Implementation of a Digitally Enabled Care Pathway (Part 2): Qualitative Analysis of Experiences of Health Care Professionals.
Background: One reason for the introduction of digital technologies into health care has been to try to improve safety and patient outcomes by providing real-time access to patient data and enhancing communication among health care professionals. However, the adoption of such technologies into clini...
| Publicado en: | Journal of Medical Internet Research Vol. 21; no. 7 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
JMIR Publications Inc.
Jul2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137896678&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137896678 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14394456 DNC jtl: Journal of Medical Internet Research issn: 14394456 maglogo: N pubinfo: dt: Jul2019 vid: 21 iid: 7 pid: 21567 pub: JMIR Publications Inc. place: Toronto, Ontario artinfo: ui: 137896678 137896678 NLM31368443 137896678 10.2196/13143 NLM31368443 137896678 ppct: 1 formats: tig: atl: Implementation of a Digitally Enabled Care Pathway (Part 2): Qualitative Analysis of Experiences of Health Care Professionals. aug: au: Connell, Alistair Black, Georgia Montgomery, Hugh Martin, Peter Nightingale, Claire King, Dominic Karthikesalingam, Alan Hughes, Cían Back, Trevor Ayoub, Kareem Suleyman, Mustafa Jones, Gareth Cross, Jennifer Stanley, Sarah Emerson, Mary Merrick, Charles Rees, Geraint Laing, Christopher Raine, Rosalind affil: Centre for Human Health and Performance, University College London, London, United Kingdom sug: subj: Health Personnel Psychosocial Factors Telemedicine Methods Qualitative Studies Human Male Female Male Female ab: Background: One reason for the introduction of digital technologies into health care has been to try to improve safety and patient outcomes by providing real-time access to patient data and enhancing communication among health care professionals. However, the adoption of such technologies into clinical pathways has been less examined, and the impacts on users and the broader health system are poorly understood. We sought to address this by studying the impacts of introducing a digitally enabled care pathway for patients with acute kidney injury (AKI) at a tertiary referral hospital in the United Kingdom. A dedicated clinical response team-comprising existing nephrology and patient-at-risk and resuscitation teams-received AKI alerts in real time via Streams, a mobile app. Here, we present a qualitative evaluation of the experiences of users and other health care professionals whose work was affected by the implementation of the care pathway.Objective: The aim of this study was to qualitatively evaluate the impact of mobile results viewing and automated alerting as part of a digitally enabled care pathway on the working practices of users and their interprofessional relationships.Methods: A total of 19 semistructured interviews were conducted with members of the AKI response team and clinicians with whom they interacted across the hospital. Interviews were analyzed using inductive and deductive thematic analysis.Results: The digitally enabled care pathway improved access to patient information and expedited early specialist care. Opportunities were identified for more constructive planning of end-of-life care due to the earlier detection and alerting of deterioration. However, the shift toward early detection also highlighted resource constraints and some clinical uncertainty about the value of intervening at this stage. The real-time availability of information altered communication flows within and between clinical teams and across professional groups.Conclusions: Digital technologies allow early detection of adverse events and of patients at risk of deterioration, with the potential to improve outcomes. They may also increase the efficiency of health care professionals' working practices. However, when planning and implementing digital information innovations in health care, the following factors should also be considered: the provision of clinical training to effectively manage early detection, resources to cope with additional workload, support to manage perceived information overload, and the optimization of algorithms to minimize unnecessary alerts. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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