Home to Stay: An Integrated Monitoring System Using a Mobile App to Support Patients at Home Following Colorectal Surgery

Background: Patients undergoing colorectal surgery are vulnerable during their transition from hospital to home and require increased support following discharge from hospital. Study objectives were to perform an initial assessment of patient uptake, outcomes, and satisfaction with an integrated discharge monitoring system called Home to Stay. Methods: The intervention was an integrated discharge monitoring system that uses a mobile app platform. Patients downloaded the app prior to discharge from hospital and received a Daily Health Check day #1 to #14, #21, and #30. Patient responses’ were accessed by the health-care team via secure web site, and extreme responses were “flagged” to indicate that a follow-up telephone call was necessary. Primary outcomes were patient uptake, Quality of Recovery scores and satisfaction with the program. Secondary outcomes were 30-day emergency room (ER) visits and readmissions. Results: One hundred and thirty-two patients were invited to participate and 106 accepted. Of these, 93 used the app at least once. The mean overall score on the Quality of Recovery Scale increased significantly from day 1 to day 14. Patient satisfaction with the app was high, with 92% of patients reporting overall satisfaction as good or excellent. The 30-day readmission rate was 6% and was lower than the 30-day readmission rate of 18% reported for the 4 months prior to the start of the study. Conclusions: The Home to Stay Program to support patients at home after colorectal surgery is feasible with high patient uptake and satisfaction. This program has the potential to reduce 30-day readmissions, however further studies are required.

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Using a Mobile App for Monitoring Post-Operative Quality of Recovery of Patients at Home: A Feasibility Study

JMIR mhealth and uhealth ◽

10.2196/mhealth.3929 ◽

2015 ◽

Vol 3 (1) ◽

pp. e18 ◽

Cited By ~ 98

Author(s):

John L Semple ◽

Sarah Sharpe ◽

M Lucas Murnaghan ◽

John Theodoropoulos ◽

Kelly A Metcalfe

Keyword(s):

Feasibility Study ◽

Mobile App ◽

Quality Of Recovery ◽

Operative Quality ◽

At Home

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Reassessment of Suicide Attempters at Home, Shortly After Discharge from Hospital

Crisis ◽

10.1027/0227-5910/a000041 ◽

2010 ◽

Vol 31 (6) ◽

pp. 303-310 ◽

Cited By ~ 9

Author(s):

Bas Verwey ◽

Jeroen A. van Waarde ◽

Molla A. Bozdağ ◽

Iris van Rooij ◽

Edwin de Beurs ◽

...

Keyword(s):

Suicide Attempt ◽

General Hospital ◽

Hospital Environment ◽

Initial Assessment ◽

Suicide Attempters ◽

Systematic Assessment ◽

Suicide Intent ◽

Initial Hospital ◽

Discharge From Hospital ◽

At Home

Background: Assessment of suicide attempters in a general hospital may be influenced by the condition of the patient and the unfavorable circumstances of the hospital environment. Aims: To determine whether the results of a reassessment at home shortly after discharge from hospital differ from the initial assessment in the hospital. Methods: In this prospective study, systematic assessment of 52 suicide attempters in a general hospital was compared with reassessment at home, shortly after discharge. Results: Reassessments at home concerning suicide intent, motives for suicide attempt, and dimensions of psychopathology did not differ significantly from the initial hospital assessment. However, patients’ motives for the suicide attempt had changed to being less impulsive and more suicidal, worrying was significantly higher, and self-esteem was significantly lower. A third of the patients had forgotten their aftercare arrangements and most patients who initially felt no need for additional help had changed their mind at reassessment. Conclusions: Results from this group of suicide attempters suggest that a brief reassessment at home shortly after discharge from hospital should be considered.

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Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

10.21203/rs.3.rs-26687/v2 ◽

2020 ◽

Author(s):

Tzu-Chieh Yin ◽

Ching-Wen Huang ◽

Hsiang-Lin Tsai ◽

Wei-Chih Su ◽

Cheng-Jen Ma ◽

...

Keyword(s):

Colorectal Surgery ◽

Minimally Invasive ◽

Perioperative Care ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Early Mobilization ◽

Quality Of Recovery ◽

Hospital Stays ◽

Minimally Invasive Colorectal Surgery

Abstract Background Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies. Methods Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge. Results Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively ( P = 0.0091 and 0.049). Conclusions Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

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The Swedish Web Version of the Quality of Recovery Scale Adapted for Use in a Mobile App: Prospective Psychometric Evaluation Study

JMIR mhealth and uhealth ◽

10.2196/mhealth.9061 ◽

2017 ◽

Vol 5 (12) ◽

pp. e188 ◽

Cited By ~ 17

Author(s):

Ulrica Nilsson ◽

Karuna Dahlberg ◽

Maria Jaensson

Keyword(s):

Psychometric Evaluation ◽

Evaluation Study ◽

Mobile App ◽

Quality Of Recovery

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IoT Based Air Quality Monitoring System

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.37337 ◽

2021 ◽

Vol 9 (VIII) ◽

pp. 402-406

Author(s):

Divya D M

Keyword(s):

Air Quality ◽

Monitoring System ◽

Mobile Application ◽

Mobile App ◽

Pollution Monitoring ◽

Contamination Level ◽

Air Quality Monitoring ◽

Air Pollution Monitoring ◽

General Wellbeing

In both created and non-industrial nations, proceeded with openness to helpless air quality is a significant general wellbeing hazard. Poisons that add to helpless air quality are thought to cause over 2.5 million unexpected losses every year all throughout the planet. To monitor things, In this undertaking, we will make an IOT-based Air Pollution Monitoring System in which we will display the quality of air in the mobile application utilizing a GSM and will set off a caution when the air quality drops under a particular range, for example when there is an enough measure of gases which are hurtful like CO2, smoke, liquor, benzene, and NH3 present noticeable all around. It will show the air quality in the proportion of PPM on the LCD and on the versatile application with the goal that we can without much of a stretch screen it. We can use our mobile app to display the contamination level in this IoT project.

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Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

10.21203/rs.3.rs-26687/v1 ◽

2020 ◽

Author(s):

Tzu-Chieh Yin ◽

Ching-Wen Huang ◽

Hsiang-Lin Tsai ◽

Wei-Chih Su ◽

Cheng-Jen Ma ◽

...

Keyword(s):

Colorectal Surgery ◽

Minimally Invasive ◽

Perioperative Care ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Early Mobilization ◽

Quality Of Recovery ◽

Hospital Stays ◽

Minimally Invasive Colorectal Surgery

Abstract BackgroundEnhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies.MethodsPatients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge.ResultsSmartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively (P = 0.0091 and 0.049).ConclusionsSmartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

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Quality of life at home and satisfaction of patients after enhanced recovery protocol for colorectal surgery*

Acta Chirurgica Belgica ◽

10.1080/00015458.2017.1279871 ◽

2017 ◽

Vol 117 (3) ◽

pp. 176-180 ◽

Cited By ~ 3

Author(s):

Aurélien Partoune ◽

Carla Coimbra ◽

Jean-François Brichant ◽

Jean Joris

Keyword(s):

Quality Of Life ◽

Colorectal Surgery ◽

Enhanced Recovery ◽

Enhanced Recovery Protocol ◽

At Home

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Swedish Web Version of the Quality of Recovery Scale Adapted for Patients Undergoing Local Anesthesia and Peripheral Nerve Blockade (SwQoR-LA): Prospective Psychometric Evaluation Study (Preprint)

10.2196/preprints.23090 ◽

2020 ◽

Author(s):

Ulrica Nilsson ◽

Karuna Dahlberg ◽

Maria Jaensson

Keyword(s):

Peripheral Nerve ◽

Real Time ◽

Nerve Block ◽

Peripheral Nerve Block ◽

Psychometric Evaluation ◽

Day Surgery ◽

Mobile App ◽

Quality Of Recovery ◽

Recovery Assessment

BACKGROUND The frequency and timing of assessing patient symptoms and discomfort during postoperative recovery are goals. Therefore, real-time recovery evaluation has been suggested to identify specific deficits in patient recovery. OBJECTIVE This study aimed to psychometrically evaluate the Swedish Web Version of the Quality of Recovery (SwQoR) Scale adapted for patients undergoing local and peripheral nerve block (SwQoR-LA). METHODS This was a secondary analysis of a psychometric evaluation of 107 patients aged ≥18 years undergoing day surgery under local or peripheral nerve block anesthesia at 4 different day surgery departments in Sweden. The SwQoR-LA, available through a mobile app called Recovery Assessment by Phone Points (RAPP), was completed daily on postoperative days 1-7. RESULTS Some evidence of construct validity was supported, and discriminant validity was found in 7 of 8 items related to general anesthesia. The internal consistency was acceptable (.87-.89), and the split-half reliability was 0.80-0.86. Cohen d effect size was 0.98, and the percentage of change from baseline was 43.4%. No floor nor ceiling effects were found. CONCLUSIONS The SwQoR-LA is valid, reliable, responsive, and clinically feasible for digital real-time recovery assessment of patient recovery to identify specific deficits in patient recovery and detect those patients who might beneﬁt from a timely intervention. CLINICALTRIAL ClinicalTrials.gov NCT02492191; https://clinicaltrials.gov/ct2/show/NCT02492191 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2015-009901

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The Swedish Web Version of the Quality of Recovery Scale Adapted for Use in a Mobile App: Prospective Psychometric Evaluation Study (Preprint)

10.2196/preprints.9061 ◽

2017 ◽

Author(s):

Ulrica Nilsson ◽

Karuna Dahlberg ◽

Maria Jaensson

Keyword(s):

Convergent Validity ◽

Psychometric Evaluation ◽

Evaluation Study ◽

Day Surgery ◽

Postoperative Recovery ◽

Mobile App ◽

Swedish Version ◽

Quality Of Recovery ◽

Item Quality

BACKGROUND The 40-item Quality of Recovery (QoR-40) questionnaire is well validated for measuring self-assessed postoperative recovery. The Swedish version of the 40-item Quality of Recovery (QoR-40) has been developed into a Web-based questionnaire, the Swedish Web version of the Quality of Recovery (SwQoR) questionnaire, adapted for use in a mobile app, Recovery Assessment by Phone Points, or RAPP. OBJECTIVE The aim of this study was to test the validity, reliability, responsiveness, and clinical acceptability and feasibility of SwQoR. METHODS We conducted a prospective psychometric evaluation study including 494 patients aged ≥18 years undergoing day surgery at 4 different day-surgery departments in Sweden. SwQoR was completed daily on postoperative days 1 to 14. RESULTS All a priori hypotheses were confirmed, supporting convergent validity. There was excellent internal consistency (Cronbach alpha range .91-.93), split-half reliability (coefficient range .87-.93), and stability (ri=.99, 95% CI .96-.99; P<.001). Cohen d effect size was 1.00, with a standardized response mean of 1.2 and a percentage change from baseline of 59.1%. An exploratory factor analysis found 5 components explaining 57.8% of the total variance. We noted a floor effect only on postoperative day 14; we found no ceiling effect. CONCLUSIONS SwQoR is valid, has excellent reliability and high responsiveness, and is clinically feasible for the systematic follow-up of patients’ postoperative recovery.

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