Tablet-Based Patient-Centered Decision Support for Minor Head Injury in the Emergency Department: Pilot Study

Singh, Navdeep; Hess, Erik P.; Guo, George; Sharp, Adam L.; Huang, Brian; Breslin, Maggie; Melnick, Edward R.

doi:10.2196/mhealth.8732

Cited by 20 publications

(13 citation statements)

References 36 publications

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“…The NPS has been used in EM in the evaluation of patient experience, as well as staff satisfaction with particular interventions; however, as far as we know, not in the assessment of staff wellbeing. We were unable to find any assessment of reliability and validity of the NPS in EM literature.…”

Section: Discussionmentioning

confidence: 99%

Workplace wellbeing in an urban emergency department in Aotearoa New Zealand

Kumar

Pio

Brewer

et al. 2019

Emerg Medicine Australasia

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Objectives: Staff wellbeing is important for individuals and considered integral to the development and maintenance of high performing health systems. Unless baseline parameters of wellbeing are known, the effects of any interventions to improve staff wellbeing will remain uncertain. By clarifying staff perceptions and objective measures of important factors related to wellbeing, our primary goal was to assess the baseline wellbeing of staff in our central city ED. Methods: A survey template, the WoWe@AED (Workplace Wellbeing at the Adult Emergency Department) was developed from several sources. Burnout was measured using the Copenhagen Burnout Inventory. Inclusion in the survey required that participants worked in our ED, all staff groups were eligible. The electronic survey was conducted between 22 January and 5 February 2018. Quantitative and qualitative data were analysed. Results: Two hundred and seventy (71.1%) of 380 potential participants participated. All staff groups were represented. About 72.4% agreed/ strongly agreed that Adult Emergency Department was an excellent place to work, 80.7% found their work meaningful. About 42.0% felt well informed regarding important decisions. One hundred and eightythree (48.2%) out of 380 completed the Copenhagen Burnout Inventory. Overall, personal burnout was 42.1% (n = 77), work-related burnout was 35% (n = 64) and clientrelated burnout was 27.9% (n = 51). Females were significantly (<0.05) more likely to have burnout in some or all domains. Four key themes were identified: supportive teamwork and relationships; providing high quality patient care; resourcing; and workload issues. Conclusions: Baseline indices of wellbeing of the frontline staff in a central city ED have been documented. These have informed wellbeing interventions. Future measures can be compared against these data.

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Section: Discussionmentioning

confidence: 99%

Workplace wellbeing in an urban emergency department in Aotearoa New Zealand

Kumar

Pio

Brewer

et al. 2019

Emerg Medicine Australasia

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“…A validated 3-item pediatric CollaboRate survey and 9-item questionnaire SDM-Q-DOC will evaluate the decisional process in medical encounters from the physicians’ perspectives at the specified time points [ 42 – 44 ]. Patient satisfaction with Coach McLungs SM will be assessed using the one-item Net Promoter Score question [ 45 – 47 ]. Fidelity refers to ensuring the shared decision-making elements are taking place and measured through the CollaboRate and SDM-Q-DOC tools.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a shared decision-making intervention for pediatric patients with asthma in the emergency department

Reeves

O’Hare

Shade

et al. 2020

Implement Sci Commun

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Background: Asthma is a difficult-to-manage chronic disease marked with associated outcome disparities including an increase rate of emergency department (ED) visits for uncontrolled asthma among patients who are most at-risk. Shared decision making (SDM) is a process by which the patient and provider jointly make a healthcare choice. SDM improves patient outcomes; however, implementation barriers of time constraints and staff availability are limitations. The use of health IT solutions may increase the adoption of SDM, but best practices for implementation are not well understood. The Consolidated Framework for Implementation Research (CFIR) is a flexible comprehensive model used to identify barriers and facilitators influencing implementation. The goal of this study is to implement an innovative web-based pediatric SDM tool in the real-world setting of two large healthcare system EDs through the following aims: (1) convene a patient, research, and ED stakeholder advisory board to oversee review of protocol and study materials prior to implementation, (2) implement the SDM intervention where providers and staff will be trained to incorporate use of this SDM intervention, (3) conduct on-going evaluation of barriers, facilitators, and implementation outcomes to tailor implementation in the EDs, (4) evaluate patientcentered outcomes of primary care utilization and changes in ED visits and hospitalizations before and after the SDM intervention, and (5) understand and document best practices for ED implementation. Methods: The CFIR model will guide the implementation evaluation. Researchers will administer surveys to the clinical team and patients at baseline, 3, 6, and 12 months to inform implementation design, determine barriers and facilitators, and resource-needs to allow for real-time process adjustments within the EDs. Focus group or keyinformant interviews and analysis will provide additional feedback to the stakeholder team to iterate the implementation process. Researchers will track patient-centered outcomes including increased primary care, ED, and inpatient utilization over the duration of the study. Discussion: To advance asthma care and the field of implementation science, further research is needed to assess best practices for incorporating SDM into high-need healthcare settings such as the ED. This knowledge will facilitate improved outcomes and appropriate policy changes towards further use of SDM interventions in local and national acute care settings.

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“…Participants completed the questionnaire after using the Web tool. The questions covered the technical feasibility and practical use of the tool, with each item graded using a 5-point Likert scale [20,21]. Additional questions centered on participants’ thoughts about daily use of computerized tools and their own habits.…”

Section: Methodsmentioning

confidence: 99%

Clinicians’ Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App

Lemey¹,

Larsen²,

DeVylder³

et al. 2019

J Med Internet Res

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Background Many mental disorders are preceded by a prodromal phase consisting of various attenuated and unspecific symptoms and functional impairment. Electronic health records are generally used to capture these symptoms during medical consultation. Internet and mobile technologies provide the opportunity to monitor symptoms emerging in patients’ environments using ecological momentary assessment techniques to support preventive therapeutic decision making. Objective The objective of this study was to assess the acceptability of a Web-based app designed to collect medical data during appointments and provide ecological momentary assessment features. Methods We recruited clinicians at 4 community psychiatry departments in France to participate. They used the app to assess patients and to collect data after viewing a video of a young patient’s emerging psychiatric consultation. We then asked them to answer a short anonymous self-administered questionnaire that evaluated their experience, the acceptability of the app, and their habit of using new technologies. Results Of 24 practitioners invited, 21 (88%) agreed to participate. Most of them were between 25 and 45 years old, and greater age was not associated with poorer acceptability. Most of the practitioners regularly used new technologies, and 95% (20/21) connected daily to the internet, with 70% (15/21) connecting 3 times a day or more. However, only 57% (12/21) reported feeling comfortable with computers. Of the clinicians, 86% (18/21) would recommend the tool to their colleagues and 67% (14/21) stated that they would be interested in daily use of the app. Most of the clinicians (16/21, 76%) found the interface easy to use and useful. However, several clinicians noted the lack of readability (8/21, 38%) and the need to improve ergonometric features (4/21, 19%), in particular to facilitate browsing through various subsections. Some participants (5/21, 24%) were concerned about the storage of medical data and most of them (11/21, 52%) seemed to be uncomfortable with this. Conclusions We describe the first step of the development of a Web app combining an electronic health record and ecological momentary assessment features. This online tool offers the possibility to assess patients and to integrate medical data easily into face-to-face conditions. The acceptability of this app supports the feasibility of its broader implementation. This app could help to standardize assessment and to build up a strong database. Used in conjunction with robust data mining analytic techniques, such a database would allow exploration of risk factors, patterns of symptom evolution, and identification of distinct risk subgroups.

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Tablet-Based Patient-Centered Decision Support for Minor Head Injury in the Emergency Department: Pilot Study

Cited by 20 publications

References 36 publications

Workplace wellbeing in an urban emergency department in Aotearoa New Zealand

Workplace wellbeing in an urban emergency department in Aotearoa New Zealand

Evaluation of a shared decision-making intervention for pediatric patients with asthma in the emergency department

Clinicians’ Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App

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