Factors influencing the successful implementation of a novel digital health application to streamline multidisciplinary communication across multiple organisations for emergency care

Abstract

RationaleDelivering optimal patient health care requires interdisciplinary clinician communication. A single communication tool across multiple pre‐hospital and hospital settings, and between hospital departments is a novel solution to current systems. Fit‐for‐purpose, secure smartphone applications allow clinical information to be shared quickly between health providers. Little is known as to what underpins their successful implementation in an emergency care context.AimsTo identify (a) whether implementing a single, digital health communication application across multiple health care organisations and hospital departments is feasible; (b) the barriers and facilitators to implementation; and (c) which factors are associated with clinicians' intentions to use the technology.MethodsWe used a multimethod design, evaluating the implementation of a secure, digital communication application (Pulsara™). The technology was trialled in two Australian regional hospitals and 25 Ambulance Victoria branches (AV). Post‐training, clinicians involved in treating patients with suspected stroke or cardiac events were administered surveys measuring perceived organisational readiness (Organisational Readiness for Implementing Change), clinicians' intentions (Unified Theory of Acceptance and Use of Technology) and internal motivations (Self‐Determination Theory) to use Pulsara™, and the perceived benefits and barriers of use. Quantitative data were descriptively summarised with multivariable associations between factors and intentions to use Pulsara™ examined with linear regression. Qualitative data responses were subjected to directed content analysis (two coders).ResultsParticipants were paramedics (n = 82, median 44 years) or hospital‐based clinicians (n = 90, median 37 years), with organisations perceived to be similarly ready. Regression results (F(11, 136) = 21.28, p = <0.001, Adj R2 = 0.60) indicated Habit, Effort Expectancy, Perceived Organisational Readiness, Performance Expectancy and Organisation membership (AV) as predictors of intending to use Pulsara™. Themes relating to benefits (95% coder agreement) included improved communication, procedural efficiencies and faster patient care. Barriers (92% coder agreement) included network accessibility and remembering passwords. PulsaraTM was initiated 562 times.ConclusionImplementing multiorganisational, digital health communication applications is feasible, and facilitated when organisations are change‐ready for an easy‐to‐use, effective solution. Developing habitual use is key, supported through implementation strategies (e.g., hands‐on training). Benefits should be emphasised (e.g., during education sessions), including streamlining communication and patient flow, and barriers addressed (e.g., identify champions and local technical support) at project commencement.

The effects and experiences of internet-delivered cognitive behavioural therapy : The perspectives of patients with non-cardiac chest pain and healthcare professionals in the emergency and cardiac care

“…The implementation of digital care technologies in healthcare aims to improve patient care, enhancing efficiency, and optimising healthcare delivery processes. However, successful implementation requires careful consideration of various factors, including organisational readiness, healthcare professionals' attitudes and behaviours, and the management of barriers and facilitators (176,177).…”

“…According to previous research, successful programs depend on the availability of easy-to-use technology; organisational and clinician acceptance and use of the technology, which can vary across departments (179,180) and hospitals (178); as well as an effective implementation strategy. Essentially, a comprehensive understanding of the unique challenges and needs of healthcare is essential for successful system implementation and improved patient care (176). According to Nilsen (181), one critical aspect highlighted in the implementation science is the importance of organisational enthusiasm and willingness for change.…”

“…Moreover, the perceived effort required to utilise these technologies needs to be minimalised to create acceptance and adoption among healthcare professionals (183). However, according to Bagot et al (176), addressing barriers to implementation is another important factor in the successful implementation of digital care technologies into healthcare practice. Establishing a local contact person for troubleshooting and clarification of technical functions (176) and management support to provide necessary resources and guidance for optimising the implementation process (184).…”