A Smartphone Application for Teamwork and Communication in Trauma: Pilot Evaluation in the Wild

Objective To evaluate the potential for a smartphone application to improve trauma care through shared and timely access to patient and contextual information. Background Disruptions along the trauma pathway that arise from communication, coordination, and handoffs problems can delay progress through initial care, imaging diagnosis, and surgery to intensive care unit (ICU) disposition. Implementing carefully designed and evaluated information distribution and communication technologies may afford opportunities to improve clinical performance. Methods This was a pilot evaluation in the wild using a before/after design, 3 month, and pre- post-intervention data collection. Use statistics, usability assessment, and direct observation of trauma care were used to evaluate the app. Ease of use and utility were assessed using the technology acceptance model (TAM) and system usability scale (SUS). Direct observation deployed measures of flow disruptions (defined as deviations from the natural progression of an procedure), teamwork scores (T-NOTECHS), and treatment times (total time in emergency department [ED]). Results The app was used in 367 (87%) traumas during the trial period. Usability was generally acceptable, with higher scores found by operating room (OR), ICU, and neuro and orthopedic users. Despite positive trends, no significant effects on flow disruptions, teamwork scores, or treatment times were observed. Conclusions Pilot trials of a clinician-centered smartphone app to improve teamwork and communication demonstrate potential value for the safety and efficiency of trauma care delivery as well as benefits and challenges of in-the-wild evaluation.

Automated summary

This study evaluated the potential of a smartphone application in improving trauma care through shared access to patient information. Despite generally acceptable usability and widespread use during the trial period, the app did not show significant effects on flow disruptions, teamwork scores, or treatment times. However, the pilot trial demonstrated the potential value of clinician-centered smartphone apps in enhancing teamwork and communication in trauma care delivery.