Change agent's role in facilitating use of technology in residential aged care: A systematic review

Abstract

Objective: To synthesise the evidence on the roles and outcomes of change agents in facilitating the use of powered technology systems and devices for staff end-users in residential aged care workplaces.

Design: Systematic review and narrative synthesis.

Data sources: CINAHL, MEDLINE and EMBASE databases were searched for articles published in English between January 2010 and July 2022.

Review methods: Two of three reviewers independently screened each title and abstract, and subsequently the full texts of selected records. The Mixed Method Appraisal Tool was used to assess the quality of the included articles.

Results: Of 3,680 records identified, ten articles reporting nine studies were included. In all the studies, the change agent role was a minor component embedded within implementation processes. Three key change agent roles were identified: 1) providing guidance, expertise, and support with implementing a new technology; 2) delivering training to others, and 3) troubleshooting and responding to issues. The key outcome of change agent roles related to achieving project implementation milestones and higher levels of implementation of technology. Change agent processes, however, were compromised when the designated change agent role was included late in the implementation process, or was not supported, recognised, embraced, or when roles or responsibilities were unclear. The direct contribution of change agents was difficult to elucidate because the roles and outcomes of change agents were embedded in multi-faceted implementation strategies.

Conclusions: The change agent can play an important role in facilitating technology implementation by providing support, training, and troubleshooting. Challenges with the change agent role included unclear role expectations and appointment late in the implementation process. Overall, there was limited evidence specific to the role and outcome of the change agent role to inform ideal approaches for their role in technology facilitation for end-users in residential aged care workplaces.

Keywords: Aged care; Champion; Change agent; Long-term care; Residential aged care (RAC); Super-user; Technology; Workforce; Workplace training.