Collaborating to use iPads as a therapeutic resource

iPads in use with the NHS

A collaborative project to introduce iPads as a therapeutic resource at Dudley and Walsall Mental Health Partnership highlights the valuable role that library services can play alongside clinical and non-clinical departments, explain Kal Dhanda and Emily Johnson.

DUDLEY and Walsall Mental Health Partnership NHS Trust Libraries have recently completed a year-long pilot in which iPads were lent out to staff to use as a therapeutic resource with patients on hospital wards and in the community. As part of the pilot, Library Services worked in collaboration with the Trust’s Occupational Therapy Department, who recommended apps and trialled the project in practice, providing feedback and recommendations.

An interactive tool

In 2012, the Occupational Therapy (OT) Department at Dudley and Walsall Mental Health Partnership NHS Trust purchased 35 iPads. The aim was to provide clinical staff with an interactive tool which could be used in therapeutic sessions with patients. A report from the University of Worcester ­indicated that the use of touch screen technology (such as iPads) could have the potential to support and enhance a number of key indicators in a patient’s life. These included supporting reminiscence and life story work, enhancing opportunities for learning, aiding recall, supporting the activities of daily living, maintaining ­interpersonal relationships, aiding creativity and enhancing and maintaining a sense of well-being.

The library’s involvement

Library Services first became involved with the OT Department’s iPads in May 2015. Due to lack of time, technical expertise, and concerns about tracking the whereabouts of the iPads, the launch of the Therapeutic iPads had been delayed by the OT Department. Library Services, who had recently introduced their own suite of loanable iPads, offered to collaborate on the project, agreeing to set up and manage the iPads; downloading any applications requested by the department and recording who was responsible for each iPad using the Library Management System – with the proviso that the iPads could become part of the library’s collection and both teams would promote the devices as an additional provision to support staff and service users.   

Setting up the iPads

Library Services held a focus group with staff from the OT Department to gain an understanding of their needs. Staff formulated a list of the apps that they felt would be most beneficial to patients. It was agreed by the group that only free apps would be downloaded due to lack of recurrent funding. These apps were split into eight different folders: Cognitive Stimulation, Psychological Therapy, Memory, Reminiscence, Activities, Communication, Sign Language and Emotions. These folders meant that staff could find the relevant apps quickly when working with patients. 
Factors such as loan periods and terms and conditions were also discussed at the focus group. It was decided that longer loan periods allowed staff more time to see any prolonged benefit from using the devices with service users.

The pilot 

Following promotion to staff, three main service groups came forward to pilot the iPads. Within the first six months of the trial there was a lot of positive feedback, which meant that several other teams were keen to get on board and joined the pilot. The pilot group was asked to indicate any problems with the usability of the iPads, their content and the library’s iPad loaning procedure. 

Positive impact on patient wellbeing

Overall the trial was perceived to have a positive impact on patient wellbeing. Staff witnessed patients engaging more with staff and other patients in therapeutic sessions. The devices also brought back positive childhood memories which worked well with some of our older patients.  

Strengths

  • All participants recommended the iPads as a therapeutic tool. One user even c­ommented that ‘the iPads have been invaluable on the ward, patients and staff have benefited from using them’.
  • The iPads supported patient care. The ­iPads were particularly therapeutic for older adults struggling with memory loss. Staff were able to use apps like Google Maps, YouTube, and Google Street View to take service users back in time in time to look at places where they used to live and work. Staff commented that this helped users to remember things they had forgotten and promote stimulating discussion. 
  • Staff found the library staff to be very helpful and supportive with all matters concerning the iPads.
  • Evidence from the literature favoured the use of iPads as a therapeutic tool
  • Staff also commented on how the devices saved staff time and money in purchasing, collecting and carrying physical resources. 

Weaknesses and limitations

  • There were issues with adverts popping up on the iPads as the free apps downloaded were funded by ads. 
  • The staff expertise and knowledge to upkeep the devices, download apps and copy apps over from one device to another lies heavily within the library service.
  • Apps have to be recommended by staff and downloaded to the device by Library Services before they can be viewed and tested with service users. 

Recommendations 
A number of recommended actions were created from the therapy iPad pilot;

  1. Library Services will look into paying for popular apps on iPads to avoid adverts popping up. 
  2. The library will consider the future of the iPads (given that they have a short life expectancy) and will come up with a plan to replace iPads in the future.
  3. The library will conduct a case study highlighting the benefits of using iPads as a therapeutic tool.

Benefits of collaborative working  

Collaborative working made the therapy iPad project a success. Without the library’s intervention, the OT Department lacked the technological skills to set up the iPads and download the apps. It would also have been difficult for OT staff to find the time to manage the project alongside their clinical duties. Conversely, without the support from the OT Department, the library would have struggled to identify which apps would be required on the iPads and may not have considered all of the practicalities of patient needs. Furthermore, the library needed the feedback and recommendations from staff who used the iPads with service users in order to improve the service for all staff and put recommendations in place. Working directly with a clinical team also enabled the library to promote the new service amongst staff groups who do not usually use the library, such as Activity Co-Ordinators and Health Care Assistants. 

In the future, library staff would like to establish the impact the iPads have had on patient well-being. To make the direct link, a number of case studies would need to be carried out over a prolonged period of time on a one-to-one basis to test the impact on service users. This investigation will form another collaborative project with the OT department.  

Library services working in collaboration with the OT Department has shown how valuable partnership working can be amongst departments. The success of the project has encouraged the library to seek out other collaborative endeavours in the future with other clinical and non-clinical departments. 

#AMillionDecisions

On Monday 30 January, CILIP and Health Education England will officially launch our joint campaign 'A Million Decisions' . The campaign will highlight the responsibility under the Health and Social Care Act 2012 to ensure the best use of available evidence within the healthcare sector, and the multiple beneficial outcomes when healthcare teams work closely with their library and knowledge services to inform decisions across the service. 

Update Magazine

This article was originally published in CILIP Update Magazine, November 2016.

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