Implementation of smart phones to facilitate in-hospital telephone communication: Challenges, successes and lessons from a neonatal intensive care unit

Driscoll, Colleen; Gurmu, Samuel; Azeem, Ahad; El-Metwally, Dina

doi:10.1016/j.hjdsi.2018.07.001

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…In a subgroup analysis of evaluating cesarean sections performed for critical fetal distress (cord prolapse and bradycardia), no differences were seen in the time to delivery (pre implementation 13.7 [range: 4-37] versus postimplementation 12.4 [range: 4-25] minutes, p ¼ 0.531), arterial pH (preimplementation 7.14 [6.81-7.34] vs. postimplementation 7.12 [6.75-7.29], p ¼ 0.284), or 5-minute Apgar's score (preimplementation 9 [range: 0-9] vs. postimplementation 8 [2][3][4][5][6][7][8][9], p ¼ 0.205).…”

Section: Resultsmentioning

confidence: 99%

“…While there were no improvements in the percent of times that the resuscitation team was present at newborn delivery, this does validate that implementation of the CM platform was not associated with delays in initiating resuscitation for newborns. This is noteworthy that small differences in the design of CM platforms can dramatically impact outcomes, 9 poorly designed platforms can lead to significant delays in patient care and potentially patient harm. The safety of our CM implementation is additionally supported by similarities in neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Over the last decade, the development of clinical mobility (CM) platforms has enhanced communication among medical providers, improving clinical workflows. [7][8][9] CM platforms facilitate the exchange of real-time bedside data to clinician's smartphones, allowing providers to respond rapidly to critical situations. 8 Such platforms allow for direct and synchronous exchange of data between care providers, patients and providers, and between medical devices and providers.…”

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confidence: 99%

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Impact of Obstetric Communication on Decision-to-Delivery Time

et al. 2022

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Objective In obstetric emergencies, care coordination is critical in achieving a “decision-to-delivery” time of 30 minutes. Reliable communication is essential to optimize coordinated care of mother and baby. Clinical mobility (CM) platforms have been shown to improve communication during medical emergencies; however, their impact on improving decision-to-delivery times has not been shown. This study aimed to determine the impact of a new CM platform on decision-to-delivery time. Study Design A multidisciplinary team designed a CM platform that employs a wall-mounted panel paired with mobile technology to alert all relevant clinical staff. This new platform uses in-room preprogrammed messages that alert predetermined responders matching the emergency. For example, the “STAT section” button summons doctors (obstetrics, anesthesiology, and neonatology), obstetric nurses, and newborn resuscitation staff via smartphones. Impact of this platform was assessed with process and outcome data: cord artery pH, 5-minute Apgar's score; and decision for cesarean section to time of: skin incision, uterine incision, and delivery. This pre- and postimplementation study (October–September 2018 vs. January–December 2019) centered on the opening of our new Obstetric Care Unit. Data were analyzed with Chi-square and Mann–Whitney U-test. Results Emergent cesarean delivery was performed in 172 women pre- and 124 postimplementation of the new CM platform. In postimplementation, we observed a 7.4-minute reduction in time from decision-to-delivery (26 pre- vs. 18.6 minutes postimplementation, p = 0.001). Delivery within 30 minutes improved by 15.2% (p = 0.018). Times to skin and uterine incision were also significantly reduced. The two groups had similar neonatal outcomes: birth weight, Apgar's score at 5 minutes, and cord artery pH did not differ, but the study was underpowered to compare these outcomes. Conclusion This new CM platform significantly reduced decision-to-delivery time, in turn improving compliance with the “30-minute rule.” All relevant personnel were contacted specifically, while avoiding overhead paging and other unnecessary messages. Key Points

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Impact of Obstetric Communication on Decision-to-Delivery Time

et al. 2022

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“…25 Telephones, mobile phones, and Web-based conferencing software have been used as a component of FCC to allow admitted patients to frequently and conveniently connect with their families, and vice versa. [26][27][28][29][30][31] This approach has been shown to be especially effective when families are separated by distance, whether this be through geographical location, military deployment, or personal and family responsibilities. More recently, during the COVID-19 pandemic, visitation restrictions in the NICU have further exacerbated the risk of family-infant estrangement and demonstrated the importance of continued logistical and technological innovation in the realm of patient-family communication.…”

Section: Nicus and Fccmentioning

confidence: 99%

“…Technology can have a role in FCC and can be especially helpful when families are distant from the NICU 25. Telephones, mobile phones, and Web-based conferencing software have been used as a component of FCC to allow admitted patients to frequently and conveniently connect with their families, and vice versa 26–31…”

Section: Literature Reviewmentioning

confidence: 99%

Virtual Visitation in a Neonatal Intensive Care Unit

Chheda

Tullius

Tejeda

et al. 2023

Journal of Perinatal &Amp; Neonatal Nursing

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This 5-year study evaluated a virtual visitation implementation initiative in a neonatal intensive care unit. Our objectives were to (1) use the Plan-Do-Study-Act methodological framework to implement a virtual visitation program, (2) investigate whether implementation of virtual visitation could be done with no patient harm and minimal workflow disruption, (3) foster a top-down participatory structure for decision making, and (4) evaluate parent use and satisfaction. The study involved a qualitative and quantitative description of cycles and results. Routine collection of outcome data allowed problems that arose as a result of changing practices to be quickly and efficiently addressed. The study results suggested that the virtual visitation implementation initiative in a neonatal intensive care unit using Plan-Do-Study-Act cycles helped create an environment of trust and provided benefits. A steady increase in the use of virtual visitation by parents and their extended families indicated utilization. During the COVID-19 pandemic, virtual visitation helped families feel connected with each other and their neonate, despite being in separate locations.

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The Socio-technical Foundations of Health Information Work

Mather

Whetton

2021

The Health Information Workforce

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Implementation of smart phones to facilitate in-hospital telephone communication: Challenges, successes and lessons from a neonatal intensive care unit

Cited by 4 publications

References 14 publications

Impact of Obstetric Communication on Decision-to-Delivery Time

Impact of Obstetric Communication on Decision-to-Delivery Time

Virtual Visitation in a Neonatal Intensive Care Unit

The Socio-technical Foundations of Health Information Work

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