Codesign of health technology interventions to support best-practice perioperative care and surgical waitlist management.

General Surgery Health Information Systems Health Services Research Medical Informatics Patient-Centered Care

Journal

BMJ health & care informatics
ISSN: 2632-1009
Titre abrégé: BMJ Health Care Inform
Pays: England
ID NLM: 101745500

Informations de publication

Date de publication:
12 Mar 2024
Historique:
received: 06 10 2023
accepted: 10 02 2024
medline: 13 3 2024
pubmed: 13 3 2024
entrez: 12 3 2024
Statut: epublish

Résumé

This project aimed to determine where health technology can support best-practice perioperative care for patients waiting for surgery. An exploratory codesign process used personas and journey mapping in three interprofessional workshops to identify key challenges in perioperative care across four health districts in Sydney, Australia. Through participatory methodology, the research inquiry directly involved perioperative clinicians. In three facilitated workshops, clinician and patient participants codesigned potential digital interventions to support perioperative pathways. Workshop output was coded and thematically analysed, using design principles. Codesign workshops, involving 51 participants, were conducted October to November 2022. Participants designed seven patient personas, with consumer representatives confirming acceptability and diversity. Interprofessional team members and consumers mapped key clinical moments, feelings and barriers for each persona during a hypothetical perioperative journey. Six key themes were identified: 'preventative care', 'personalised care', 'integrated communication', 'shared decision-making', 'care transitions' and 'partnership'. Twenty potential solutions were proposed, with top priorities a digital dashboard and virtual care coordination. Our findings emphasise the importance of interprofessional collaboration, patient and family engagement and supporting health technology infrastructure. Through user-based codesign, participants identified potential opportunities where health technology could improve system efficiencies and enhance care quality for patients waiting for surgical procedures. The codesign approach embedded users in the development of locally-driven, contextually oriented policies to address current perioperative service challenges, such as prolonged waiting times and care fragmentation. Health technology innovation provides opportunities to improve perioperative care and integrate clinical information. Future research will prototype priority solutions for further implementation and evaluation.

Identifiants

pubmed: 38471784
pii: bmjhci-2023-100928
doi: 10.1136/bmjhci-2023-100928
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Hector Blamey (H)
Carina Cutmore (C)
Lilijana Gorringe (L)
Cherry Leslie (C)
Andrew Marks (A)
Kate McBride (K)
Nicole Phillips (N)
Angus Ritchie (A)
Robert Sanders (R)
Danielle Slater (D)
Michael Solomon (M)

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Sarah Joy Aitken (SJ)

Sydney Medical School, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia sarah.aitken@sydney.edu.au.
Concord Institute of Academic Surgery, Sydney Local Health District, Concord West, New South Wales, Australia.

Sophie James (S)

The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Amy Lawrence (A)

Anaesthetics, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Anthony Glover (A)

The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Department of Surgery and Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

Henry Pleass (H)

The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia.

Janani Thillianadesan (J)

The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Geriatrics, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Sue Monaro (S)

Clinical Excellence Commission, Sydney South, New South Wales, Australia.
Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Kerry Hitos (K)

The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Westmead Hospital, Westmead, New South Wales, Australia.

Vasi Naganathan (V)

The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Classifications MeSH