Marshall Andrew D A, Hasdianda Mohammad Adrian, Miyawaki Steven, Jambaulikar Guruprasad D, Cao Chenze, Chen Paul, Baugh Christopher W, Zhang Haipeng, McCabe Jonathan, Steinbach Lee, King Scott, Friedman Jason, Su Jennifer, Landman Adam B, Chai Peter Ray
Department of Emergency Medicine, Harvard Medical School, Boston, MA, United States.
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States.
JMIR Form Res. 2023 Mar 21;7:e44725. doi: 10.2196/44725.
Electronic paper (E-paper) screens use electrophoretic ink to provide paper-like low-power displays with advanced networking capabilities that may potentially serve as an alternative to traditional whiteboards and television display screens in hospital settings. E-paper may be leveraged in the emergency department (ED) to facilitate communication. Providing ED patient status updates on E-paper screens could improve patient satisfaction and overall experience and provide more equitable access to their health information.
We aimed to pilot a patient-facing digital whiteboard using E-paper to display relevant orienting and clinical information in real time to ED patients. We also sought to assess patients' satisfaction after our intervention and understand our patients' overall perception of the impact of the digital whiteboards on their stay.
We deployed a 41-inch E-paper digital whiteboard in 4 rooms in an urban, tertiary care, and academic ED and enrolled 110 patients to understand and evaluate their experience. Participants completed a modified Hospital Consumer Assessment of Health Care Provider and Systems satisfaction questionnaire about their ED stay. We compared responses to a matched control group of patients triaged to ED rooms without digital whiteboards. We designed the digital whiteboard based on iterative feedback from various departmental stakeholders. After establishing IT infrastructure to support the project, we enrolled patients on a convenience basis into a control and an intervention (digital whiteboard) group. Enrollees were given a baseline survey to evaluate their comfort with technology and an exit survey to evaluate their opinions of the digital whiteboard and overall ED satisfaction. Statistical analysis was performed to compare baseline characteristics as well as satisfaction.
After the successful prototyping and implementation of 4 digital whiteboards, we screened 471 patients for inclusion. We enrolled 110 patients, and 50 patients in each group (control and intervention) completed the study protocol. Age, gender, and racial and ethnic composition were similar between groups. We saw significant increases in satisfaction on postvisit surveys when patients were asked about communication regarding delays (P=.03) and what to do after discharge (P=.02). We found that patients in the intervention group were more likely to recommend the facility to family and friends (P=.04). Additionally, 96% (48/50) stated that they preferred a room with a digital whiteboard, and 70% (35/50) found the intervention "quite a bit" or "extremely" helpful in understanding their ED stay.
Digital whiteboards are a feasible and acceptable method of displaying patient-facing data in the ED. Our pilot suggested that E-paper screens coupled with relevant, real-time clinical data and packaged together as a digital whiteboard may positively impact patient satisfaction and the perception of the facility during ED visits. Further study is needed to fully understand the impact on patient satisfaction and experience.
ClinicalTrials.gov NCT04497922; https://clinicaltrials.gov/ct2/show/NCT04497922.
电子纸(E-paper)屏幕使用电泳墨水来提供类似纸张的低功耗显示屏,并具备先进的联网功能,这有可能在医院环境中替代传统的白板和电视显示屏。电子纸可用于急诊科(ED)以促进沟通。在电子纸屏幕上提供急诊科患者状态更新信息可以提高患者满意度和整体体验,并使患者更公平地获取其健康信息。
我们旨在试用一款面向患者的数字白板,该白板使用电子纸实时向急诊科患者显示相关的引导信息和临床信息。我们还试图评估干预后患者的满意度,并了解患者对数字白板对其就诊影响的总体看法。
我们在一家城市三级医疗学术急诊科的4个房间中部署了一块41英寸的电子纸数字白板,并招募了110名患者来了解和评估他们的体验。参与者完成了一份经过修改的医疗服务提供者和系统医院消费者评估满意度问卷,内容涉及他们在急诊科的就诊情况。我们将这些回答与分诊到没有数字白板的急诊科房间的匹配对照组患者的回答进行了比较。我们根据各部门利益相关者的迭代反馈设计了数字白板。在建立支持该项目的信息技术基础设施后,我们以便利为原则将患者纳入对照组和干预组(数字白板组)。参与者接受了一项基线调查以评估他们对技术的舒适度,并接受了一项出院调查以评估他们对数字白板的看法和对急诊科的总体满意度。进行了统计分析以比较基线特征和满意度。
在成功制作并安装了4块数字白板的原型后,我们筛选了471名患者以纳入研究。我们招募了110名患者,每组(对照组和干预组)各有50名患者完成了研究方案。两组之间的年龄、性别以及种族和民族构成相似。当患者被问及有关延误的沟通情况(P = 0.03)以及出院后该怎么做(P = 0.02)时,我们发现就诊后调查中的满意度有显著提高。我们发现干预组的患者更有可能向家人和朋友推荐该医疗机构(P = 0.04)。此外,96%(48/50)的患者表示他们更喜欢有数字白板的房间,70%(35/50)的患者认为该干预措施在帮助他们了解急诊科就诊情况方面“非常”或“极其”有用。
数字白板是在急诊科显示面向患者数据的一种可行且可接受的方法。我们的试点研究表明,电子纸屏幕结合相关的实时临床数据并打包成数字白板,可能会对患者满意度以及在急诊科就诊期间对医疗机构的看法产生积极影响。需要进一步研究以充分了解其对患者满意度和体验的影响。
ClinicalTrials.gov NCT04497922;https://clinicaltrials.gov/ct2/show/NCT04497922