JMIR Publications

ABSTRACT

Background:

The United States is experiencing a direct support professional (DSP) crisis, with demand far exceeding supply. Although generating documentation is a critical responsibility, it is one of the most wearisome aspects of DSPs’ jobs. Technology that enables DSPs to log informal, timestamped notes throughout their shift could help reduce the burden of end-of-shift documentation and increase job satisfaction, which in turn could improve quality of life of the individuals with intellectual and developmental disabilities (IDD) that they support. However, DSPs, with varied ages, levels of education, and comfort using technology, are not likely to adopt tools that detract from caregiving responsibilities or increase workload, so technology for them must be relatively simple, extremely intuitive, and provide highly valued capabilities.

Objective:

This paper describes the development and pilot testing of technology, called Digital Assistant Tools (DAT), that enable DSPs to create informal notes throughout their shifts and use these notes to facilitate end-of-shift documentation. The purpose of the pilot study was to assess the usability, acceptability and feasibility of the DAT. Preliminary effectiveness data were also collected.

Methods:

The research team applied an established user-centered, participatory design process to develop and test the DAT prototypes between May 2020 and April 2023. Pilot testing entailed having 14 DSPs who support adults with IDD use the DAT prototypes during two or three successive work shifts and fill out demographic, acceptability, and usability questionnaires.

Results:

Participants used the DAT prototypes to create notes and help generate end-of-shift reports. The average System Usability Scale (SUS) score of 81.79 indicates that they found the tools easy to use. Survey responses imply that using the DAT prototypes made it easier for participants to produce required documentation and suggest that participants would adopt the DAT if they were available for daily use.

Conclusions:

Simple technologies such as the DAT prototypes, which enable DSPs to use mobile devices to log time-stamped notes throughout their shift with minimal effort, have the potential to both reduce the burden associated with producing documentation and enhance the quality (level of detail and accuracy) of that documentation. This can help to increase job satisfaction and reduce turnover in DSPs, both of which can help improve quality of life of the individuals with IDD that they support. Pilot testing results indicate DSPs are likely to adopt DAT. Next steps include a) producing more robust versions of the DAT prototypes with additional capabilities, such as storing data locally on mobile devices when wifi is not available, and b) eliciting input from agency directors, families, and others who use data about adults with IDD to help care for those adults, to ensure that data produced by DSPs are relevant and useful.