PIMPmyHospital: a Mobile App to Improve Emergency Care Efficiency and Communication
Condition: Pediatric Emergency Medicine; Communication
MeSH terms: Emergencies
Study type: Interventional

Summary: 
      This pilot study is a prospective, single-center, randomized, controlled trial in a tertiary
      pediatric emergency department with two parallel groups of voluntary post-graduate year [PGY]
      1 to 5 pediatric residents and registered pediatric emergency nurses. The impact of an
      mHealth support tool will be compared to conventional methods on the retrieval of laboratory
      data from the patient's electronic record, and on team collaboration in a semi-simulated
      emergency department environment. Ten participants are randomized (1:1). The primary endpoint
      is the time from the availability of new laboratory results for a given patient to their
      consideration by participants, measured in minutes using a stopwatch.
    

Detailed description: 
      Emergency care is very complex in that it requires patient-centered care in a coordinated
      manner among multiple providers in a highly distractible, unpredictable, multi-tasking, and
      stressful environment. Due to the inherent characteristics of specimen processing and
      laboratory instruments, the turnaround time from laboratory test ordering to availability of
      results can be long. As a result, caregivers must continue their multiple tasks while waiting
      for these results and, in the absence of reminder alerts, they must remember to check their
      availability. This can lead to oversights or delays in their consideration. Lack of follow-up
      of abnormal laboratory results can lead to missed information that could impact patient care
      and safety. Moreover, sharing information efficiently between providers in this environment
      is difficult. Caregivers are often far away from each other, busy with their tasks, without
      the ability to quickly communicate face-to-face with their colleagues to exchange important
      information regarding their patients.

      Connecting emergency service providers to each other through a digital communication channel
      could improve the efficiency of synchronous information sharing and emergency care, as well
      as instant retrieval of laboratory results at the point of care. To this end, the
      investigators have developed a mobile application (app) dedicated to emergency department
      caregivers, PIMPmyHospital (Patients In My Pocket in my Hospital [PMID 34734879]). This app
      aims to provide relevant information in real time about the patients ED caregivers are caring
      for, including laboratory results, as well as a chat and secure messaging platform to
      virtually connect physicians and nurses caring for the same patients.

      This clinical trial is a pilot, prospective, single-center, randomized, controlled trial in a
      tertiary pediatric emergency department (>33,000 consultations/year) with two parallel groups
      of voluntary PGY 1 to 5 pediatric residents and registered pediatric emergency nurses. It
      aims to assess the impact of the app in a real pediatric emergency department environment
      through standardized, semi-simulated scenarios. Ten participants (5 residents and 5 nurses)
      are randomized 1:1.

      During their actual clinical tasks, each participant is asked to take note of laboratory
      results about a fictional patient that randomly occur once during the course of the scripted
      scenario, using either the app (study arm A) or conventional methods (study arm B), and
      secondly, to then respond to requests from a remote colleague to go to a specific location in
      the emergency room to assist with a technical procedure (the request being relayed either by
      the app or one of the study investigators depending on the study arm allocation).

      The primary endpoint is the time from the availability of new laboratory results to their
      consideration by participants, measured in minutes using a stopwatch.

      The secondary endpoint is the time from when the participant is informed that a colleague
      requires his or her assistance to perform a technical procedure to when the participant
      reaches that colleague, measured in minutes using a stopwatch.

      Data collection is carried out by two study investigators. Deidentified data are safely
      stored in duplicate on papers and secured hard-disk drives in a locked room at the Geneva
      Children's Hospital, Switzerland. This study offers the major advantage to observe a unique
      period per participant during their regular shift. Therefore, neither follow-up nor retention
      plans is necessary. The REDCap database (REDCap, Vanderbilt University, Nashville, TN, USA)
      will be used for data collection. Study data will be de-identified and a master linking log
      (code key) with identifiers (ie, participant identification list on paper format) will be
      kept and stored separately from the data by the study investigators in a secured cabinet in a
      locked room at Geneva Children's Hospital, Switzerland, under the responsibility of the
      principal investigator.

      This clinical trial will assess the impact of a collaborative mHealth tool to increase timely
      medical information retrieval at the point of care and team communication in an emergency
      department. The results of this pilot study will be used to set up a larger randomized
      controlled trial. As research in this area is scarce, the results generated from this study
      could be of importance to improve in-hospital pediatric emergency care practice and
      communication in an era of communication technologies.
    

Intervention name(s): PIMPmyHospital (mHealth tool); Conventional method
Intervention type(s): Device; Other
Intervention description(s): Each participant will first be asked to retrieve a factious patient's laboratory results on the app when randomly made available, and then reach a colleague (role played by a study investigator) when asked to do so by a text message on the app.; Each participant will first be asked to retrieve a factious patient's laboratory results from the emergency department's computerized patient data system when randomly made available, and then contact a colleague (role played by a study investigator) when asked to do so (request made by a second study investigator).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, single center, randomized, controlled trial
Masking: Single (Participant)
Primary purpose: Basic Science
Keywords: Information technologies; Mobile Applications; Laboratory Result Delivery; Information Storage and Retrieval; Hospital Communication Systems; Communication; Pediatric Emergency Medicine; Emergency Department