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Published on: August 1, 2019
Reducing clinician burden with an e-health platform for pediatric gastrostomy tube education: The One-4-ALL
Shannon N Acker1, Catherine Dawson-Gore1, Ana Ibarra Meraz2
1Research Outcomes in Children's Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA; Department of Surgery, Division of Pediatric Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Background:
We previously created an e-health tool, the One-4-ALL initiative, to provide perioperative education to families of children undergoing gastrostomy tube (GT) placement. The tool includes written content, photos, and videos describing the operation, postoperative care, complications, and home trouble shooting techniques. The current aim is to understand the impact of implementation of the One-4-ALL initiative on the clinical team including impact on workflow and sustainability.
Methods:
We conducted a type 2 hybrid implementation-effectiveness study to evaluate the impact of our e-health platform on members of our healthcare team. Effectiveness was assessed via pre-post study design first through quantitative assessment of time spent responding to family questions regarding GTs and via survey of the members of the healthcare team before and after e-health platform implementation to assess burden of providing perioperative GT education. Acceptability and sustainability of the e-health platform were assessed via survey and semi-structured interviews of healthcare providers who enrolled families in the e-health platform.
Results:
During the study period 207 GTs were placed; 69 families created an e-health account (33.3 %). Following implementation of the e-health platform, the number of phone calls and messages via the electronic health record decreased from 52 to 34 messages in a two-week period. The percentage of providers reporting "patients do not collaborate as much as desired" decreased. Providers who enrolled families in the e-health platform reported the tool was relevant to their patients, the amount of time and resources required to enroll families was acceptable, and they planned to continue to offer the tool to their patients.
Conclusions:
Implementation of an e-health platform for perioperative education directed at families of children undergoing GT surgery had a positive impact on the provider team by decreasing the burden associated with providing education to families. These data will be used to support ongoing efforts to distribute the One-4-ALL e-health tool to all families of children who undergo GT placement at our center while supporting the development of additional e-health tools.
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