Mignault Alexandre, Tchouaket Nguemeleu Éric, Robins Stephanie, Maillet Éric, Matetsa Edwige, Dupuis Stéphane
Bloc Opératoire, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Département des sciences infirmières, Université du Québec en Outaouais, St-Jérome, QC, Canada.
JMIR Perioper Med. 2022 May 6;5(1):e36208. doi: 10.2196/36208.
Undergoing a surgical procedure is anxiety provoking for patients and their caregivers. During the intraoperative period, caregivers seek out informational updates from health care professionals, a situation complicated by COVID-19 health measures that require caregivers to wait outside the hospital. Short messaging service (SMS)-based communication that allows caregivers to follow their loved ones through surgery has shown promise in relieving anxiety and improving satisfaction with overall care. This form of communication is also well accepted by health care professionals and may be effective at relieving staff burden.
Here, we describe a quality improvement initiative of a standardized and integrated intraoperative SMS-based system to improve communication between surgical teams and caregivers. The main goal was to improve satisfaction with care, while the secondary goal was to reduce caregiver anxiety.
The initiative followed the framework of the Model for Improvement. A large tertiary care hospital offered the SMS to caregivers who were waiting for loved ones undergoing surgery. SMS messages were integrated into the clinical information system software and sent at key points during the surgical journey to phone numbers provided by caregivers. A satisfaction survey was sent to caregivers 1 business day after surgery. Data were collected between February 16 and July 14, 2021.
Of the 8129 surgeries scheduled, caregivers waiting for 6149 (75.6%) surgeries agreed to receive SMS messages. A total of 34,129 messages were sent. The satisfaction survey was completed by 2088 (34%) of the 6149 caregivers. Satisfaction with messages was high, with the majority of respondents reporting that the messages received were adequate (1476/2085, 70.8%), clear (1545/2077, 74.4%), informative (1488/2078, 71.6%), and met their needs (1234/2077, 59.4%). The overall satisfaction score was high (4.5 out of 5), and caregivers reported that receiving text messages resulted in a reduction in anxiety (score=8.2 out of 10). Technical errors were reported by 69 (3.3%) caregivers. Suggestions for improvements included having messages sent more often; providing greater patient details, including the patient's health status; and the service being offered in other languages.
This digital health initiative provided SMS messages that were systematically sent to caregivers waiting for their loved ones undergoing surgery, just as COVID-19 restrictions began preventing waiting onsite. The messages were used across 15 surgical specialties and have since been implemented hospital-wide. Digital health care innovations have the capacity to improve family-centered communication; what patients and their families find useful and appreciate will ultimately determine their success.
接受外科手术会让患者及其护理人员感到焦虑。在手术期间，护理人员会向医护人员寻求信息更新，而新冠疫情防控措施要求护理人员在医院外等候，这使得情况变得复杂。基于短信服务（SMS）的通信方式能让护理人员在手术过程中随时了解亲人的情况，在缓解焦虑和提高对整体护理的满意度方面已显示出成效。这种通信形式也很受医护人员欢迎，可能有助于减轻工作人员的负担。
在此，我们描述一项质量改进举措，即建立一个标准化、集成化的术中基于短信服务的系统，以改善手术团队与护理人员之间的沟通。主要目标是提高护理满意度，次要目标是减轻护理人员的焦虑。
该举措遵循改进模式的框架。一家大型三级护理医院向等待亲人接受手术的护理人员提供短信服务。短信被集成到临床信息系统软件中，并在手术过程中的关键节点发送到护理人员提供的电话号码上。术后1个工作日向护理人员发送满意度调查问卷。数据收集时间为2021年2月16日至7月14日。
在计划进行的8129例手术中，等待6149例（75.6%）手术的护理人员同意接收短信。共发送了34129条短信。6149名护理人员中有2088名（34%）完成了满意度调查。对短信的满意度很高，大多数受访者表示收到的短信足够（1476/2085，70.8%）、清晰（1545/2077，74.4%）、信息丰富（1488/2078，71.6%），且满足他们的需求（1234/2077，59.4%）。总体满意度得分很高（满分5分，得4.5分），护理人员表示收到短信后焦虑感有所减轻（满分10分，得8.2分）。69名（3.3%）护理人员报告了技术错误。改进建议包括增加短信发送频率；提供更多患者详细信息，包括患者的健康状况；以及提供其他语言的服务。
这项数字健康举措提供了系统发送给等待亲人接受手术的护理人员的短信，当时正值新冠疫情限制措施开始阻止护理人员在现场等候之际。这些短信在15个外科专科中得到应用，此后已在全院实施。数字医疗创新有能力改善以家庭为中心的沟通；患者及其家人认为有用和感激的内容最终将决定其是否成功。
