scholarly journals Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study

10.2196/16989 ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. e16989
Author(s):  
Merle A J Geerds ◽  
Wieke S Nijmeijer ◽  
J H Hegeman ◽  
Miriam M R Vollenbroek-Hutten
Keyword(s):  
Quality Of Care ◽  
Hip Fracture ◽  
The Netherlands ◽  
Hip Fractures ◽  
Cognitive Disorders ◽  
Mobile App ◽  
Technical Problems ◽  
Facilitating Conditions

Background As a result of an aging population, there has been an increasing incidence of hip fractures worldwide. In the Netherlands, in order to improve the quality of care for elderly patients with hip fractures, the multidisciplinary Centre for Geriatric Traumatology was established in 2008 at the Department of Trauma Surgery at Ziekenhuisgroep Twente hospital (located in Almelo and Hengelo in the Netherlands). Objective Though the Dutch Hip Fracture audit is used to monitor the quality of care for patients with fractures of the hip, only 30.7% of patients complete registration in the 3-month follow-up period. Mobile apps offer an opportunity for improvement in this area. The aim of this study was to investigate the usability and acceptance of a mobile app for gathering indicators of quality of care in a 3-month follow-up period after postoperative treatment of hip fracture. Methods From July 2017 to December 2017, patients who underwent surgical treatment for hip fracture were recruited. Patients and caregivers, who were collectively considered the participant cohort, were asked to download the app and answer a questionnaire. Participants were divided into two groups—those who downloaded the app and those who did not download the app. A telephone interview that was based upon the Unified Theory of Acceptance and Use of Technology was conducted with a subset of participants from each group (1:1 ratio). This study was designated as not being subject to the Dutch Medical Research Involving Human Subjects Act according to the appropriate medical research ethics committees. Results Of the patients and caregivers who participated, 26.4% (29/110) downloaded the app, whereas 73.6% (81/110) did not. Telephone interviews with the subset of participants (n=24 per group) revealed that 54.0% (13/24) of the group of participants who did not download the app had forgotten the study. Among the group who downloaded the app, 95.8% (23/24) had the intention of completing the questionnaire, but only 4.2% (1/24) did so. The reasons for not completing the questionnaire included technical problems, cognitive disorders, or patient dependency on caregivers. Most participants in the group who downloaded the app self-reported a high level of expertise in using a smartphone (22/24, 91.7%), and sufficient facilitating conditions for using a smartphone were self-reported in both groups (downloaded the app: 23/24, 95.8%; did not download the app: 21/24, 87.5%), suggesting that these factors were not barriers to completion. Conclusions Despite self-reported intention to use the app, smartphone expertise, and sufficient facilitating conditions for smartphone use, implementation of the mobile app was infeasible for daily practice. This was due to a combination of technical problems, factors related to the implementation process, and the population of interest having cognitive disorders or a dependency on caregivers for mobile technology.

scholarly journals Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study (Preprint)

2019 ◽  
Author(s):  
Merle A J Geerds ◽  
Wieke S Nijmeijer ◽  
J H Hegeman ◽  
Miriam M R Vollenbroek-Hutten
Keyword(s):  
Quality Of Care ◽  
Hip Fracture ◽  
The Netherlands ◽  
Hip Fractures ◽  
Cognitive Disorders ◽  
Mobile App ◽  
Technical Problems ◽  
Facilitating Conditions

BACKGROUND As a result of an aging population, there has been an increasing incidence of hip fractures worldwide. In the Netherlands, in order to improve the quality of care for elderly patients with hip fractures, the multidisciplinary Centre for Geriatric Traumatology was established in 2008 at the Department of Trauma Surgery at Ziekenhuisgroep Twente hospital (located in Almelo and Hengelo in the Netherlands). OBJECTIVE Though the Dutch Hip Fracture audit is used to monitor the quality of care for patients with fractures of the hip, only 30.7% of patients complete registration in the 3-month follow-up period. Mobile apps offer an opportunity for improvement in this area. The aim of this study was to investigate the usability and acceptance of a mobile app for gathering indicators of quality of care in a 3-month follow-up period after postoperative treatment of hip fracture. METHODS From July 2017 to December 2017, patients who underwent surgical treatment for hip fracture were recruited. Patients and caregivers, who were collectively considered the participant cohort, were asked to download the app and answer a questionnaire. Participants were divided into two groups—those who downloaded the app and those who did not download the app. A telephone interview that was based upon the Unified Theory of Acceptance and Use of Technology was conducted with a subset of participants from each group (1:1 ratio). This study was designated as not being subject to the Dutch Medical Research Involving Human Subjects Act according to the appropriate medical research ethics committees. RESULTS Of the patients and caregivers who participated, 26.4% (29/110) downloaded the app, whereas 73.6% (81/110) did not. Telephone interviews with the subset of participants (n=24 per group) revealed that 54.0% (13/24) of the group of participants who did not download the app had forgotten the study. Among the group who downloaded the app, 95.8% (23/24) had the intention of completing the questionnaire, but only 4.2% (1/24) did so. The reasons for not completing the questionnaire included technical problems, cognitive disorders, or patient dependency on caregivers. Most participants in the group who downloaded the app self-reported a high level of expertise in using a smartphone (22/24, 91.7%), and sufficient facilitating conditions for using a smartphone were self-reported in both groups (downloaded the app: 23/24, 95.8%; did not download the app: 21/24, 87.5%), suggesting that these factors were not barriers to completion. CONCLUSIONS Despite self-reported intention to use the app, smartphone expertise, and sufficient facilitating conditions for smartphone use, implementation of the mobile app was infeasible for daily practice. This was due to a combination of technical problems, factors related to the implementation process, and the population of interest having cognitive disorders or a dependency on caregivers for mobile technology. INTERNATIONAL REGISTERED REPORT RR2-10.2196/RR1

scholarly journals RACIAL DISPARITIES IN HIP FRACTURE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S469-S469
Author(s):  
Iman Ali ◽  
Jessica Jang ◽  
Sanjana Vattigunta ◽  
Ankit Bansal ◽  
Uma Srikumaran
Keyword(s):  
Quality Of Care ◽  
Hip Fracture ◽  
Racial Disparities ◽  
Hip Fractures ◽  
Quality Care ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Outcome Variable ◽  
Black Patients

Abstract Hip fractures are associated with significant morbidity and mortality. Delaying surgery for more than 24 hours after presentation results in more complications, higher 30-day mortality rate, and longer stays in the hospital. As such, high-quality care should be provided consistently to an increasingly diverse patient population. We determined if race characteristics influence the quality of care provided to patients with hip fractures. We conducted a retrospective analysis on patients at our institution between January 2015 and December 2017. Patients were categorized as white, Black, Asian, and other. The primary outcome variable was the time between presentation to surgery. Other outcomes included length of hospital stay and narcotic pain medication consumption in the first 24 hours postoperatively. Adjusted analysis was performed, controlling for sex, age, body mass index (BMI), American Society of Anesthesiologists’ (ASA) classification of health, and Charlson Comorbidity Index (CCI). There were 1544 hip fracture patients included in the study. The majority of patients were white (84.1%) followed by Black (7.6%), Asian (4.5%), and other (3.7%). Most patients were female (69.6%). After adjusting for patient characteristics, Black patients experienced a significantly greater delay to surgery after presentation than white patients (42.1 vs. 34.9 hours). In addition, Black patients experienced significantly longer length of hospital stays compared to their white counterparts (6.9 vs. 5.8 days). Racial disparities in the quality of care provided to hip fracture patients persist even after adjusting for patient characteristics. Addressing these disparities can possibly enhance outcomes for minority patients.

What can a mobile App add to improve quality of care, with focus on ambulatory surgery?

2018 ◽  
Vol 6 (1) ◽  
pp. 20 ◽  
Author(s):  
Metha Brattwall ◽  
Magareta Warrén Stomberg ◽  
Pether Jildenstål ◽  
Irene Sellbrandt ◽  
Jan G Jakobsson
Keyword(s):  
Quality Of Care ◽  
Enhanced Recovery ◽  
Effective Means ◽  
Mobile App ◽  
Mobile Telephone ◽  
Hospital Length Of Stay ◽  
Surgical Patient ◽  
Operative Recovery

Rationale, aims and objectives: Many surgical procedures are nowadays performed as ambulatory or short stay procedures, reducing hospital length of stay. Patient safety and quality of care remain imperative especially when adopting enhanced recovery pathways. Patients should be adequately informed and prepared prior to admission. Recovery is to a major extent dependent after discharge on self-care and thus techniques to follow the post-operative course after leaving hospital are warranted. Telemedicine has grown tremendously over recent years and the incorporation of mobile telephone app technology for the pre- and post-operative coaching of the ambulatory surgical patient may represent an effective means of assisting patients. The present paper presents a feasibility study of a mobile telephone app providing pre-operative information and following the post-operative recovery following day surgery.Method: Patients scheduled for elective day surgery were asked to participate, testing the app and to assess its usefulness on visual analogue scales.Results: Sixty-nine patients aged 18 to 73 years tested the app. Patients aged 30 to 50 where the most frequent users and patients < 30 less frequent. The app was in general assessed as useful and most users expressed an interest in the option of having an app as a source of information before undergoing a scheduled procedure. General pre-operative information was assessed as the most important. A willingness to submit follow-up information decreased rapidly, only 26 and 16 responded at day 10 and 30, respectively.Conclusion: A mobile telephone app is a feasible and appreciated tool for pre-operative information and coaching as part of person-centered healthcare, but its use for follow-up after discharge is challenging and requires further investigation.

scholarly journals Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands

2010 ◽  
Vol 32 (4) ◽  
pp. 368-376 ◽  
Author(s):  
Thijs Fassaert ◽  
Mark Nielen ◽  
Robert Verheij ◽  
Arnoud Verhoeff ◽  
Jack Dekker ◽  
...  
Keyword(s):  
Quality Of Care ◽  
The Netherlands ◽  
Ethnic Groups ◽  
Urban Areas ◽  
Anxiety And Depression ◽  
Family Practitioners

scholarly journals Health-related quality of life after vertebral or hip fracture: a seven-year follow-up study

2009 ◽  
Vol 10 (1) ◽  
Author(s):  
Inger Hallberg ◽  
Margareta Bachrach-Lindström ◽  
Staffan Hammerby ◽  
Göran Toss ◽  
Anna-Christina Ek
Keyword(s):  
Quality Of Life ◽  
Hip Fracture ◽  
Health Related Quality ◽  
Follow Up Study ◽  
Related Quality ◽  
Health Related

scholarly journals Effect of a primary care based epilepsy specialist nurse service on quality of care from the patients’ perspective: results at two-years follow-up

Seizure ◽  
1999 ◽  
Vol 8 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Nicola Mills ◽  
Max O. Bachmann ◽  
Rona Campbell ◽  
Iain Hine ◽  
Mervyn McGowan
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Specialist Nurse ◽  
Patients Perspective

scholarly journals Comparison of two Dutch follow-up care models for spinal cord-injured patients and their impact on health problems, re-admissions and quality of care

2007 ◽  
Vol 21 (11) ◽  
pp. 997-1006 ◽  
Author(s):  
J.H.A. Bloemen-Vrencken ◽  
L.P. de Witte ◽  
M.W.M. Post ◽  
C. Pons ◽  
F.W.A. van Asbeck ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Quality Of Care ◽  
Health Problems ◽  
Follow Up Care ◽  
Care Models ◽  
Injured Patients ◽  
Spinal Cord Injured

scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands (Preprint)

2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

scholarly journals Quality of care and 30 day mortality among patients with hip fractures: a nationwide cohort study

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Katrine A Nielsen ◽  
Niels C Jensen ◽  
Claus M Jensen ◽  
Marianne Thomsen ◽  
Lars Pedersen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Quality Of Care ◽  
Hip Fractures
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