Jill de Grood

Medical applications: a database and characterization of apps in Apple iOS and Android platforms

BackgroundMedical applications (apps) for smart phones and tablet computers are growing in number and are commonly used in healthcare. In this context, there is a need for a diverse community of app users, medical researchers, and app developers to better understand the app landscape.MethodsIn mid-2012, we undertook an environmental scan and classification of the medical app landscape in the two dominant platforms by searching the medical category of the Apple iTunes and Google Play app download sites. We identified target audiences, functions, costs and content themes using app descriptions and captured these data in a database. We only included apps released or updated between October 1, 2011 and May 31, 2012, with a primary “medical” app store categorization, in English, that contained health or medical content. Our sample of Android apps was limited to the most popular apps in the medical category.ResultsOur final sample of Apple iOS (n = 4561) and Android (n = 293) apps illustrate a diverse medical app landscape. The proportion of Apple iOS apps for the public (35%) and for physicians (36%) is similar. Few Apple iOS apps specifically target nurses (3%). Within the Android apps, those targeting the public dominated in our sample (51%). The distribution of app functions is similar in both platforms with reference being the most common function. Most app functions and content themes vary considerably by target audience. Social media apps are more common for patients and the public, while conference apps target physicians.ConclusionsWe characterized existing medical apps and illustrated their diversity in terms of target audience, main functions, cost and healthcare topic. The resulting app database is a resource for app users, app developers and health informatics researchers.

Shifting perceptions: a pre-post study to assess the impact of a senior resident rotation bundle

BackgroundExtended duty hours for residents are associated with negative consequences. Strategies to accommodate duty hour restrictions may also have unintended impacts. To eliminate extended duty hours and potentially lessen these impacts, we developed a senior resident rotation bundle that integrates a night float system, educational sessions on sleep hygiene, an electronic handover tool, and a simulation-based medical education curriculum. The aim of this study was to assess internal medicine residents’ perceptions of the impact of the bundle on three domains: the senior residents’ wellness, ability to deliver quality health care, and medical education experience.MethodsThis prospective study compared eligible residents’ experiences (N = 67) before and after a six-month trial of the bundle at a training program in western Canada. Data was collected using an on-line survey. Pre- and post-intervention scores for the final sample (N = 50) were presented as means and compared using the t-test for paired samples.ResultsParticipants felt that most aspects of the three domains were unaffected by the introduction of the bundle. Four improved and two worsened perception shifts emerged post-intervention: less exposure to personal harm, reduced potential for medical error, more successful teaching, fewer disruptions to other rotations, increased conflicting role demands and less staff physician supervision.ConclusionsThe rotation bundle integrates components that potentially ease some of the perceived negative consequences of night float rotations and duty hour restrictions. Future areas of study should include objective measures of the three domains to validate our study participants’ perceptions.

Evaluation of a hands-free communication device in an acute care setting: a study of healthcare providers' perceptions of its performance.

Quality medical care hinges on healthcare providers being able to communicate effectively and efficiently. In this study, we examine if healthcare providers’ perceptions of the performance of a wireless communication device are consistent with what it is claimed the technology can offer, namely, improved patient safety and quality of care. We used a mixed-methods design where we collected data from a single medical unit. During the qualitative component of the study, we conducted face-to-face interviews to explore healthcare team members’ perceptions of the impact of a wireless communication device on their day-to-day patient care activities. Three major improvements were identified from the interview data: more direct and effective communication, improved work efficiency, and enhanced continuity of patient care. The quantitative component consisted of a questionnaire constructed from the major themes extracted from the interviews. Many of the healthcare team members reported that the wireless communication device improved their communication and allowed them to complete their work more efficiently. In addition, the questionnaire findings suggest that both improved communication and work efficiency are correlated with perceptions of improved quality of patient care. Based on the results of this study, this wireless communication device does live up to its aims of enhancing communication, staff efficiency, and improving perceived patient safety.

How evidence from observing attending physicians links to a competency-based framework

Competency‐based medical education frameworks are often founded on a combination of existing research, educational principles and expert consensus. Our objective was to examine how components of the attending physician role, as determined by observing preceptors during their real‐world work, link to the CanMEDS Physician Competency Framework.

The impact of the use of video-based educational interventions on patient outcomes in hospital settings: A scoping review

OBJECTIVE To summarize the literature on the impact of video-based educational interventions on patient outcomes in inpatient settings as compared to standard education techniques. METHODS This review followed a scoping review methodology. English language articles were searched in Pubmed, Medline, Cochrane, and CINAHL databases. Inclusion criteria were: use of video-based educational interventions, and inpatient hospital settings. Abstracts were reviewed and selected according to predetermined criteria, followed by full-text scrutiny. RESULTS Sixty-two empirical studies were identified, with 38 (61%) reporting a significant positive effect of video-based educational interventions on patient outcomes, compared to control groups (i.e., standard education). Three different types of video-based educational intervention formats were identified: animated presentations, professionals in practice, and patient narratives. Outcome types included: knowledge-based, clinical, emotional, and behavioral, with knowledge-based most prevalent. CONCLUSION Video-based educational interventions are common in the hospital setting. These interventions are effective at improving short-term health literacy goals, but their impact on behavior or lifestyle modifications is unclear. Their effectiveness also depends on presentation format, timing, and the patients emotional well-being. PRACTICE IMPLICATIONS Video-based educational delivery is effective for improving short-term health literacy, however a combination of approaches delivered over an extended period of time may support improving longer-term health outcomes.

Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada

HighlightsAlmost three quarters (70%) of sites reported having at least one outbreak in 2013, and ward closure was utilized in 44% of the sites.Overcapacity was perceived to be the main limitation on the implementation of ward closure. Over three quarters of sites had an Overcapacity/Full Capacity Protocol (OCP/FCP), and 63% of those respondents reported that this protocol was used “frequently” or “continuously”.Ward closure was considered as an appropriate strategy either in general by 50% or sometimes, under some circumstances by 45%.Respondents who said that ward closure was “sometimes” appropriate indicated that it would be so only if other measures fail, after a risk assessment, or depending on the nature and extent of the outbreak.Responses indicated that ward closure was generally used for acute and virulent enteric and respiratory outbreaks, but not outbreaks involving antibiotic resistant organisms (AROs). Background: Ward closure is a method of controlling hospital‐acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. Purpose: To understand the current practices and perceptions with respect to ward closure for hospital‐acquired infectious disease outbreaks in acute care hospital settings across Canada. Methods: A Web‐based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed‐methods approach of descriptive statistics and thematic analysis. Results: A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an “appropriate,” “sometimes appropriate,” or “not appropriate” strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Discussion: Results suggest the use of ward closure for containment of hospital‐acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration.