Mobilt dokumentationssystem inom hemtjänsten/Tidsregistrerings- och dokumentationssystemet, ParaGå

Background
Name of your initiative: 
Mobilt dokumentationssystem inom hemtjänsten/Tidsregistrerings- och dokumentationssystemet, ParaGå
Short name (acronym): 
ParaGå
Website title and address: 
Tidsregistrering (Time Registration)
Which organization is submitting this initiative?: 
The Elderly Services Administration, City of Stockholm
Please specify in which regions/provinces: 
SVERIGEÖSTRA SVERIGEStockholmStockholms län
City: 
City of Stockholm
Where is this organization located?: 
Sweden
Please enter the name of the contact person for this initiative: 
Raili Karlsson
Please enter the email of the contact for this initiative: 
raili.karlsson@stockholm.se
Part of larger strategy or programme: 
No
If you answered "other", please specify: 
Please provide us with more details of this programme or strategy: 
The status of the initiative: 
Completed
Please give a summary of your initiative (in English): 
The time registration system ParaGå enables better monitoring, improved quality and more efficient administration. With ParaGå, the municipality can monitor the amount of time care providers spend in/attend the elderlys home in a completely different way, so that the elderly people get the time and services they are paying for and the city re-imburses. Before, this was manually handled. Today, about 6 000 people regularly use ParaGå to register visits and other kind of services provided. Each month a total of one million visits to nearly 20 000 people with home care services, is registered. MORE TIME FOR THE ELDERLY PERSON For the home care providers, the new system stimulates more time spent at the elderly person's home. It is now also possible for the municipality assessors to follow up the services provided. At the same time this also saves Money both for the municipality and for the (private) home care providers. All staff within home care service has been equipped with smart phones and through the application ParaGå Android - which is connected to the City's IT-system, they register the time spent with the elderly and are also able to make journal entries/notes.
The geographical scope: 
Local
Type of initiative: 
Public
Environment or setting of the initiative: 
Urban
The economic environment or setting of the initiative: 
Rich
The most important source of funding for your initiative: 
Local funding
If other, please specify your source of funding: 
What triggered this initiative?: 
The background for this investment is that it has long been a problem for the municipality not being able to overview/control the time for provided home care, whereas very few home care providers have registered non performed time, meaning that their reimbursment has been higher than it should have been. The ParaGå system allows flexibility in terms of adjusting the duration of a visit in the elderly persons's home. Before the launch the 1st of January 2014, there were two years of preparational work consisting of cooperation between elderly people, steering groups, reference groups, working groups, managing the opinions from District Administrations, organizations and industry councils. Furthermore, a significant training program directed at the managers within the elderly care organisations on the distributional side. Hundreds of staff within both private and municipal home care service, as well as for the care assessors, has been trained. Also, thousands of staff have received training through e-Learning.
Objectives
What are the main objectives of your initiative? Choose a maximum of 3 objectives.: 
Community support and health services: increase in client-oriented and -centered made to measure health and social care and services
Please describe any subgoals of your initiative: 
Target group
Does your initiative target people with a specific impairment or disease?: 
How many people have you reached or do you expect to reach with your initiative?: 
10.000 - 100.000
Does your initiative target a specific age group?: 
65 - 7980+
Does your initiative target men or women?: 
Irrelevant
Approach
Please indicate what best describes your initiative: 
ImplementationICTMonitoring
What type of intervention strategy is used in your initiative?: 
Please indicate the Technology Readiness Level (TRL) of your initiative: 
Prototype and implementation: level 7-9
Who executes the initiative: 
Provider of social service
What is the relevant physical scale of your initiative?: 
BuildingIn a care settingBuildingIn a residential settingCity/municipalityRoomIn a care settingRoomIn a residential setting
Please indicate how you think your initiative could be scaled up (made to reach more people): 
ParaGå has been implemented in the whole City of Stockholm. The implementation phase took part in several steps - a few City Districts at a time. This is order to ensure that possible technical issues/difficulties encountered could be well managed. The full potential of the ParaGå system has yet not been reached - it could e.g. be used in a way where the information is used to stimulate development and innovation in the field of organisational development & social innovation.
Please indicate the type of stakeholders concerned with your initiative.: 
Private companySmall and medium-sized enterprises (SME)Provider of social serviceResidential long-term care facilities
Please describe how you think your initiative could be transferred to other regions or contexts: 
First of all, the technical prerequisites need to be in place, i.e. an IT infrastructure. Sufficient education must also be provided in advance for all different sectors of staff being affected by the change. (Please reed more under key success factors, below.)
Is your initiative economically sustainable and does it contribute to economic development?: 
Yes.
If you selected "other" neighbourhood, please specify:: 
Impact & outcome
Will you collect or have you collected outcome data for this initiative?: 
Yes
What do you consider the key success factors of your initiative? If your initiative has not yet started, please indicate what you expect the key success factors to be: 
In order for the new system to be successfull, it had to be accepted among the users, i.e. both among the staff providing the home care services and among the elderly people. Hence there is a significant part of work that needs to be done in terms of communication; it is e.g. important to stress that the GPS function isn't - or even can't be - used in a purpose to monitor/"supervise" the home care staff 24/7. It is simply used in order to verify a visit in the elderly person's home by comparing the positional marks of the staff to the coordinators of the elderly person's home adress registered in the documentational system. One of the goals was to ensure a better/legal certainty for the elderly person by being able to follow up that the granted services is being carried out/provided. The success depends on that the incentive system has improved/changed. There is now a technical possibility to follow up on the provided services. - Incentives, reimbursment system - Technical platform - High compliance TESTIMONIAL FROM HOME CARE STAFF "Being able to access the documentational system while in the home of the elderly person, is a great advantage. The other night we arrived at an elderly person's home, finding that both the upper and lower lock of the entrance door was locked. By reading previous journal entries we were able to see that the elderly person was away, visiting a relative for a few days. With the older system/without ParaGå, we would have had to go back to the office in order to find this out but now we weere able to save this time (which instead could be used providing service/spending more time for other eldelry people)."
What do you consider the main barriers to overcome in your initiative? If your initiative has not yet started, please indicate what you expect the main barriers to be.: 
The biggest initial barrier/challenge was to reach acceptans of the system among the staff (compliance). Today the challenge is to get the decision makers within the system (i.e. both care assessors, home care service managers and home care staff) to use the generated information for change and development initiatives. This has the potential to lead to a better organisation of elderly care and consequently to higher quality care. The initial project objective was to calibrate the whole system in order for the costs to be the same as before or lower while the amount of provided services would increase. The evaluation shows that this has been achieved. The evaluation has three main purposes: - Create a basis for continuous development of ParaGå - improvements and new features - Provide a basis for the design of further support and training to both care assessors/managers and home care providers - Provide a basis for the development of the organization and work processes of both the City Administration and providers The components to be evaluated are: - Regulatory framework for the reimbursment to the home care providers - Working methods and processes within and between the City and the home care providers - Technical support system and its components.
What instruments will you use/have used to collect data?: 
Other, namely
If you selected "other" instrument to collect data, please specify: 
If yes, how will you/have you collected those data?: 
Mixed-methodsQualitative evaluation
Will you collect or have collected socio-economic impact data for this initiative?: 
No
Will or are the collected data in the initiative publicly available?: 
No