The MediShout App: Communication, Control and Capturing Staff Voice During Covid-19 (Preprint)
Authors: Kalraiya Ashish , Walker Ben , Rajendran Shiron , Vivekanantham Sayinthen , Sharpe Danny , Gilmour Ian 
Published: June 2020

BACKGROUND

Covid-19 is exacerbating pre-existing pressures on healthcare systems. Frontline staff are relying more than usual on effective logistics and infrastructure to deliver patient care, for example provision of PPE, stock, facilities and equipment. Staff must adapt their ways of working in response to new challenges. Traditional communication channels within hospitals are often inefficient and not digitised, preventing healthcare organisations from adequately supporting staff and providing efficient solutions to problems.

OBJECTIVE

This study deployed the MediShout mobile phone application (app) to capture real-time data, on problems with logistics and infrastructure occurring in hospitals during the Covid-19 pandemic. The main objectives were to determine whether; healthcare staff would use the app, reporting led to immediate improvements, and data-collection could drive long-term transformational change and improve responses to future pandemics.

METHODS

The app was used by staff to report issues with logistics and infrastructure across two hospital emergency departments (EDs) at Imperial College Healthcare Trust, UK. These reports were acted upon by senior physicians and nurses, operational managers and service helpdesks. Data was collected from the start of the first peak of Covid-19 in the UK, between March and April 2020. Data from each report were retrospectively analysed across multiple categories, including problem description and time of submission. To gauge the impact of each issue on clinical care, reports were scored against an impact scoring tool using a modified version of the World Health Organisation’s ‘quality of care’ definition.

RESULTS

During this study, 94 reports were submitted. Reporting peaks were observed at times corresponding to clinical handovers. Peaks were also observed when changes had occurred to existing processes within the EDs. Impact analysis highlighted that every report sent had ‘impact’ or ‘significant impact’ on various aspects of care, including efficiency, patient safety and timely treatment.

CONCLUSIONS

The MediShout app captured valuable real-time data from frontline staff during the peak of Covid-19. Staff readily adopted the digital technology as it provided a more efficient way to resolve issues. This enabled hospitals to better allocate scarce resources, such as PPE, to those who needed it most. This study suggests listening to the voice of frontline staff during times of crisis allows more effective responses.

Capturing data during pandemics is critical for healthcare organisations to learn lessons and maintain control. During this study, it was established that most problems occurred due to changes in practice, such as dividing EDs into Covid-19 and non-Covid-19 zones, rather than increased caseload. Logistical and infrastructure issues were categorised as being “material” (stock, equipment, medicines, or estates and facilities) or “workflow” (task-management, new ways of working, infection control and communication) in nature. This provides healthcare organisations with a methodical tool for risk-assessing and coordinating future pandemic responses.

CLINICALTRIAL

n/a