Accepted for/Published in: JMIR Human Factors
Date Submitted: Feb 9, 2023
Date Accepted: Jul 22, 2023
Implementing Electronic Discharge Communication Tools in Pediatric Emergency Departments: A Multi-Country, Cross-Sectional Readiness Survey of Nurses and Physicians
ABSTRACT
Background:
Pediatric emergency departments (ED) in many countries are implementing electronic tools (EDCTs) such as kiosks, mobile apps, electronic patient portals, to improve the effectiveness of discharge communication.
Objective:
This study aimed to leverage an implementation framework to help identify interdependencies that impact nurse and physician readiness to adopt these tools.
Methods:
An electronic, cross-sectional survey was distributed to currently practicing ED nurses and physicians affiliated with national pediatric research organizations in Canada, Australia and New Zealand. Survey development was informed by the seven domains of the Non-Adoption, Abandonment, Scale-up, Spread, Sustainability (NASSS) framework. Measures of central tendency, parametric and non-parametric tests were employed to describe and compare nurse and physician responses.
Results:
Of 270 participants, the majority were physicians (61%), female (65%) and had five or more years of ED experience (76%). There were high levels of consensus related to the value proposition of EDCTs with 82% agreeing they help parents and patients with comprehension and recall. Lower levels of consensus were observed for organizational factors with only 37% agreeing that their staff is equipped to handle challenges with communication technologies. Nurses and physicians showed statistically significant differences on 3/21 readiness items. One third (33%) of participants indicated they use or have used EDCT.
Conclusions:
Despite low levels of uptake, both nurses and physicians in multiple countries view EDCTs as a valuable support to families visiting pediatric emergency departments. Leadership for technology change, unclear impact on workflow and disparities in digital literacy skills require focused research effort.
Citation
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