354 Improving Perioperative Communication Using a Mobile Application

Abstract

INTRODUCTION: Introduction of perioperative measures, such as the pre-operative time out, has shown to improve communication and outcomes across various surgical subspecialties. We utilized a standardized preoperative workflow using a technological platform in an effort to reduce operative inefficiency and improve preparedness. METHODS: Data was collected prospectively from neurosurgical cases before (July – October 2020) and after (October – January 2021) implantation of a mobile app designed to improve perioperative workflow and communication. All faculty and residents operating at the MUSC University Hospital during the intervention period were invited to use the mobile application. We used a double-blinded design to assess surgical team performance over the data collection period. The circulating/scrub nurses/technicians completed surveys detailing impression of resident preparedness, operative teamwork, last minute requests, near misses, and patient safety reports. Analysis of the cases in the intervention period was based on participating neurosurgical attendings, regardless of whether the cases were assigned, briefed, and/or debriefed on the application. RESULTS: 112 cases were performed over the duration of the study period. Perception of resident preparation (0-5 score) was 4.13 before and 4.66 after implementation of the app (P<0.05). Resident familiarity (0-5 score) was 4.23 before and 4.58 after (P<0.05). Adverse events occurred in 11 pre-app cases and 4 in post app cases (P=0.77). Patient safety intelligence reports occurred in 0 cases before and after implementation. Impression of case efficiency averaged 4.48 (0-5) before use of the app and 4.61 after (P<0.05). CONCLUSION: Use of the mobile app significantly increased perceived resident preparedness, familiarity of the case plan, and teamwork. There were fewer adverse events after use of the app, however this did not reach statistical significance. There was no change in patient safety intelligence events following implementation of the app.