Amina Tariq1, Melissa Baysari2, Claus H Pedersen3, Mie V Andersen3, Malene M Larsen3, Majid Shahi4, Alexander Beveridge5, Johanna Westbrook6. 1. School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia; Centre of Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia. Electronic address: a.tariq@qut.edu.au. 2. Centre of Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia. 3. Department of Health Science and Technology, Aalborg University, Denmark. 4. Xavier 7 North, St Vincent's Hospital, Sydney, Australia. 5. Geriatrics Department, St Vincent's Hospital, Sydney, Australia. 6. Centre of Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Abstract
BACKGROUND: The dynamic environment that characterizes patient care in hospitals requires extensive communication between staff. Electronic status board applications are used to improve the flow of communication in hospitals. To date there has been limited work exploring the adoption of these applications in general acute ward settings. AIM: This study aimed to identify barriers to the adoption of an electronic patient journey board (EPJB)1 application in acute wards of a hospital. METHOD: Data were collected at a large public teaching hospital in Sydney, Australia. The EPJB was implemented across all hospital wards with the aim of improving multidisciplinary communication in wards. Observations (29.5 h) and contextual interviews (n = 33) with hospital staff were conducted in two acute wards of the hospital. RESULTS: Two manual whiteboards were used on wards, in addition to the EPJB, to compensate for information not being available or accessible on the EPJB. Despite the stated purpose of the EPJB, the tool did not appear to support team communication on wards. Barriers to adoption and optimal use of the EPJB included inappropriate location and configuration of the system, limitations in information timeliness, quality and lack of customisation (for different user groups), inconsistent information updates and the absence of a shared understanding of the purpose of the EPJB among the various user groups. CONCLUSION: Multiple socio-technical barriers influenced uptake and optimal use of the EPJB by healthcare providers. Engaging users early in the design and implementation of electronic status board applications is required to ensure effective use of these complex interventions on general wards.
BACKGROUND: The dynamic environment that characterizes patient care in hospitals requires extensive communication between staff. Electronic status board applications are used to improve the flow of communication in hospitals. To date there has been limited work exploring the adoption of these applications in general acute ward settings. AIM: This study aimed to identify barriers to the adoption of an electronic patient journey board (EPJB)1 application in acute wards of a hospital. METHOD: Data were collected at a large public teaching hospital in Sydney, Australia. The EPJB was implemented across all hospital wards with the aim of improving multidisciplinary communication in wards. Observations (29.5 h) and contextual interviews (n = 33) with hospital staff were conducted in two acute wards of the hospital. RESULTS: Two manual whiteboards were used on wards, in addition to the EPJB, to compensate for information not being available or accessible on the EPJB. Despite the stated purpose of the EPJB, the tool did not appear to support team communication on wards. Barriers to adoption and optimal use of the EPJB included inappropriate location and configuration of the system, limitations in information timeliness, quality and lack of customisation (for different user groups), inconsistent information updates and the absence of a shared understanding of the purpose of the EPJB among the various user groups. CONCLUSION: Multiple socio-technical barriers influenced uptake and optimal use of the EPJB by healthcare providers. Engaging users early in the design and implementation of electronic status board applications is required to ensure effective use of these complex interventions on general wards.
Authors: Carleene Bañez; Stefano Gelmi; Nikki Bansil; Rachel Drebit; Shirley Solomon; Jennifer Yoon; Vanessa Burkoski; Barbara Collins; Trevor Hall Journal: BMJ Open Qual Date: 2021-01