“There’s an app for that!” Improving Communication and Increasing Transparency from the Operating Room.
“Don’t cry, everything will be OK, I’ll be with you when you wake up” reassured Madison’s mom as her tearful 3 year old daughter disappeared beyond the operating room doors. That stark sign “Surgery, no access beyond this point. Authorized personnel only” was still etched in her memory as she sat down in the crowded waiting room. It was a familiar ritual, Madison, born with hypoplastic left heart syndrome, was undergoing her third open heart surgery in her short life. The alert and vibration of her cell phone somewhat startled her, but as she opened the thumbnail picture on the screen in front of her, she was overcome with a sense of calm, “Madison is safely off to sleep and doing great”.
EASE (Electronic Access to Surgical Events), is a mobile app that allows clinicians to send customized texts, photos and videos from the operating room to family and friends in the waiting room (and beyond) utilizing secure encryption in order to comply with HIPAA regulations.
Over the last two decades, families have demanded more involvement in their loved ones’ care and to have increased access during their hospital stay. From allowing parents in the operating room for the induction of their child’s anesthesia, to families participating in ICU rounds, and fathers being present in the delivery room during a Caesarian section birth, family involvement and participation in healthcare is growing exponentially. Families may even be present during resuscitation in an emergency room. The one area that is still very much “behind closed doors” is the modern operating room. This is for obvious sterility concerns, spacial limitations and the potential for distraction of health care providers.
Recently the US News and World Report complied a list of the top 10 grievances that patients had regarding their hospital stay, and lack of clear communication was on that list. “Update me and my family if you notice changes in my condition”. “Keep communication open”. “Please keep me informed of delays, it lessens my anxiety during an already stressful time.”
What more stressful time can there be for a family, than that time spent in a surgical waiting room while a loved one undergoes a medical procedure?
We live in an instant world. Instant gratification, instant information and instant communication. Technology has allowed this change. Over two thirds of the world’s estimated population of 7 billion people own a smart phone and there are more phones sold per day than babies born. On average, people spend 282 minutes per day using their phone, that’s nearly 5 hours! Surely we can harness this technology to improve communication within healthcare.
In an article written by for the American Medical Association titled Patient Satisfaction: History, Myths, and Misperceptions by Richard Bolton Siegrist, Jr., MBA, MS, CPA, he observed that a common myth amongst hospitals, is the notion that “If we build a nice new building, patient satisfaction scores will go up. It is easy to attribute low satisfaction scores to over-utilized capacity or a lack of recent capital investment in newer facilities. While these may contribute somewhat in certain circumstances, spending more money does not necessarily increase patient satisfaction.”
Developed by anesthesiologists with an intimate knowledge of the requirements of a busy operating room, the app is easy to install and for the patients family to connect. A simple registration process is followed by the family deciding whether they would like to receive texts, texts and photos or texts, photos and videos (provided the surgeon allows all three). A popular feature is the ability to invite additional family and friends who could not make it to the hospital, to receive updates. Once a picture or video is received, loved ones have 60 seconds of viewing time before the update disappears, and nothing is stored on either the sender or recipients device. For the nurses sending the updates (typically the OR circulator), all that is required following logging in, is to scan a unique QR code and they are ready to go. A new language feature contains 18 pre-formed messages in Spanish, and the app maintains a time stamped log of the updates sent. Research conducted by EASE has shown that families feel increasingly anxious if they have not heard anything for approximately 30 minutes. With this in mind, the app sends an audible reminder every 30 minutes. “It is so seamless, it just becomes second nature,” says pediatric cardiac surgical nurse Kara Dobson, BSN, RN, PCCN. “It is so natural to take out my phone and text when I am not at work that it easily becomes routine at work.” The app actually makes communicating with the family easier and doesn’t disrupt the workflow as much as making a call,” says Dobson. “I can send a quick text and keep going.”
A recently completed study of over 2000 families who had experienced EASE found that 98% said receiving updates during their loved one’s medical procedure reduced their anxiety, while 97% indicated that the images they viewed were appropriate. In addition, 80% of the respondents said that the availability of EASE would influence their choice of hospital in the future. Families can submit comments within the app at the end of surgery. One mother recently wrote, “I felt like I was in the surgery room with her, it’s like she never left my arms.”
Nationwide Children’s Hospital in Columbus, OH has been using the EASE Platform for over a year. Ashley Hodge, MBA, CCP, FPP; CV Surgery Quality & Safety Officer, was responsible for introducing EASE to the hospital. After a successful pilot, Hodge was effusive in her praise. “They were creating exactly what I had envisioned, it was one of the most fabulous things that has happened from a patient experience standpoint.” The EASE solution has sent patient satisfaction scores even higher, from 80% to 97.5%. Hodge directly attributes this to the implementation of EASE, as nothing else changed.
Six and a half hours and 12 updates later, Madison’s mom hugged the surgeon gratefully. “Everything had gone as planned” he explained, but she already knew, EASE had made sure of that…