Objective

To evaluate the potential for a smartphone application to improve trauma care through shared and timely access to patient and contextual information.

Background

Disruptions along the trauma pathway that arise from communication, coordination, and handoffs problems can delay progress through initial care, imaging diagnosis, and surgery to intensive care unit (ICU) disposition. Implementing carefully designed and evaluated information distribution and communication technologies may afford opportunities to improve clinical performance.

Methods

This was a pilot evaluation “in the wild” using a before/after design, 3 month, and pre- post-intervention data collection. Use statistics, usability assessment, and direct observation of trauma care were used to evaluate the app. Ease of use and utility were assessed using the technology acceptance model (TAM) and system usability scale (SUS). Direct observation deployed measures of flow disruptions (defined as “deviations from the natural progression of an procedure”), teamwork scores (T-NOTECHS), and treatment times (total time in emergency department [ED]).

Results

The app was used in 367 (87%) traumas during the trial period. Usability was generally acceptable, with higher scores found by operating room (OR), ICU, and neuro and orthopedic users. Despite positive trends, no significant effects on flow disruptions, teamwork scores, or treatment times were observed.

Conclusions

Pilot trials of a clinician-centered smartphone app to improve teamwork and communication demonstrate potential value for the safety and efficiency of trauma care delivery as well as benefits and challenges of “in-the-wild” evaluation.

中文翻译：

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创伤中团队合作和沟通的智能手机应用程序：“野外”试点评估

客观的

评估智能手机应用程序通过共享和及时访问患者和上下文信息来改善创伤护理的潜力。

背景

由沟通、协调和交接问题引起的创伤路径中断可能会延迟从初始护理、影像诊断和手术到重症监护病房 (ICU) 处置的进展。实施精心设计和评估的信息分发和通信技术可能会提供改善临床表现的机会。

方法

这是使用设计前/后、3 个月和干预后数据收集“在野外”进行的试点评估。使用统计、可用性评估和创伤护理的直接观察用于评估该应用程序。使用技术接受模型（TAM）和系统可用性量表（SUS）评估易用性和实用性。直接观察部署了流动中断（定义为“偏离程序的自然进展”）、团队合作评分（T-NOTECHS）和治疗时间（急诊科总时间[ED]）的测量。

结果

在试用期间，该应用程序被用于 367 例 (87%) 的创伤。可用性总体上是可以接受的，手术室 (OR)、ICU 以及神经和骨科用户的得分较高。尽管有积极的趋势，但没有观察到对流动中断、团队合作得分或治疗时间的显着影响。

结论

以临床医生为中心的智能手机应用程序旨在改善团队合作和沟通的试点试验证明了创伤护理提供的安全性和效率的潜在价值以及“野外”评估的好处和挑战。