JMIR Publications

ABSTRACT

Background:

Undergoing a surgical procedure is anxiety provoking for patients and their caregivers. During the intra-operative period, caregivers seek out informational updates from healthcare professionals, a situation complicated by COVID-19 health measures that require caregivers to wait outside the hospital. SMS-based communication that allows caregivers to follow their loved ones through surgery has shown promise in relieving anxiety and improving satisfaction with overall care. This form of communication is also well accepted by healthcare professionals and may be effective at relieving staff burden.

Objective:

Here we describe a quality improvement initiative of a standardized and integrated intra-operative SMS-based system to improve communication between surgical teams and caregivers. The main goal was to reduce improve satisfaction with care, a secondary goal was to reduce caregiver anxiety.

Methods:

A large tertiary care hospital offered the SMS service to caregivers who were waiting for loved ones undergoing surgery. SMS messages were integrated into the clinical information system software and sent at key points during the surgical journey to phone numbers provided by caregivers. A satisfaction survey was sent to caregivers one business day after surgery. Data were collected between Feb 16th and July 14th 2021.

Results:

Of the 8,129 surgeries scheduled, caregivers waiting for 6,149 surgeries (76%) agreed to receive SMS messages. A total of 34,129 messages were sent. The satisfaction survey was completed by 2,088/6,149 or 34 % of caregivers. Satisfaction with messages was high, with the majority of respondents reporting the messages received were adequate (71%), clear (74%), informative (72%) and met their needs (60%). The overall satisfaction score was high (4.5 out of 5) and caregivers reported that receiving text messages resulted in a reduction in anxiety (score 8.2 out of 10). Technical errors were reported by 68 caregivers. Suggestions for improvements included having messages sent more often, providing greater patient details including the patient’s health status, and the service being offered in other languages.

Conclusions:

This digital health initiative provided SMS messages that were systematically sent to caregivers waiting for their loved ones undergoing surgery, just as COVID-19 restrictions prevented waiting onsite. The messages were used across 15 surgical specialties and have since been implemented hospital wide. Digital healthcare innovations have the capacity to improve family centered communication; what patients and their families find useful and appreciated will ultimately determine their success.