Andrew L Chu1,2,3,4, Yonatan G Keschner2, Lucinda Lai1,2,3, Joshua J Baugh1, Christopher W Baugh2, Paul D Biddinger1, Ali S Raja1, Eric M Isselbacher4,5, Jared Conley1,4. 1. Department of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USA. 2. Department of Emergency Medicine Brigham & Women's Hospital Boston Massachusetts USA. 3. Harvard Affiliated Emergency Medicine Residency Program Boston Massachusetts USA. 4. Healthcare Transformation Lab Massachusetts General Hospital Boston Massachusetts USA. 5. Department of Medicine Massachusetts General Hospital Boston Massachusetts USA.
Abstract
BACKGROUND: Although emergency departments (ED) have standardized guidelines for low-frequency, high-acuity diagnoses, they are not immediately accessible at the bedside, and this can cause anxiety in trainees and delay patient care. This problem is exacerbated during events like COVID-19 that require the rapid creation, iteration, and dissemination of new guidelines. METHODS: Physician innovators used design thinking principles to develop EM Protocols (EMP), a mobile application that clinicians can use to immediately view guidelines, contact consultants (e.g., cath lab activation), and access code-running tools. The project became an institutional high priority, because it helps EM trainees and off-service rotators manage low-frequency, high-acuity emergencies at the point of care, and its COVID-19 guidelines can be rapidly updated and disseminated in real time. RESULTS: This intervention was deployed across two academic medical centers during the COVID-19 surge. Nearly 300 ED clinicians have downloaded EMP, and they have interacted with the app over 5,400 times. It continues to be used regularly, over 12 months after the initial surge. Since the app was received positively, there are efforts to build in additional adult and pediatric guidelines. DISCUSSION: Digital health tools like EMP can serve as invaluable adjuncts for managing acute, life-threatening emergencies at the point of care. They can benefit trainees during normal day-to-day operations as well as scenarios that cause large-scale operational disruptions, such as natural disasters, mass casualty events, and future pandemics.
BACKGROUND: Although emergency departments (ED) have standardized guidelines for low-frequency, high-acuity diagnoses, they are not immediately accessible at the bedside, and this can cause anxiety in trainees and delay patient care. This problem is exacerbated during events like COVID-19 that require the rapid creation, iteration, and dissemination of new guidelines. METHODS: Physician innovators used design thinking principles to develop EM Protocols (EMP), a mobile application that clinicians can use to immediately view guidelines, contact consultants (e.g., cath lab activation), and access code-running tools. The project became an institutional high priority, because it helps EM trainees and off-service rotators manage low-frequency, high-acuity emergencies at the point of care, and its COVID-19 guidelines can be rapidly updated and disseminated in real time. RESULTS: This intervention was deployed across two academic medical centers during the COVID-19 surge. Nearly 300 ED clinicians have downloaded EMP, and they have interacted with the app over 5,400 times. It continues to be used regularly, over 12 months after the initial surge. Since the app was received positively, there are efforts to build in additional adult and pediatric guidelines. DISCUSSION: Digital health tools like EMP can serve as invaluable adjuncts for managing acute, life-threatening emergencies at the point of care. They can benefit trainees during normal day-to-day operations as well as scenarios that cause large-scale operational disruptions, such as natural disasters, mass casualty events, and future pandemics.
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