130 Patient Preference for Receiving Their Discharge Instructions From the Emergency Department

Abstract

Study Objectives: To study the effectiveness of a mobile app-based strategy to improve door-to-needle time in the treatment of acute ischemic stroke in an emergency department in Kerala, India.Methods: This was a study of consecutively presenting patients who were admitted to the emergency department at Baby Memorial Hospital between April 2017 -March 2018 with acute stroke. The mobile application (app) included fields for patient parameters, a timer, the NIH stroke scale (NIHSS), the thrombolysis checklist and a tPA (tissue plasminogen activator) dose calculator. The app also enabled team synchronization by notifying all on-call members and team leaders of the patient movement in real time, along with sharing of radiological images.Door to needle time (DNT) captured from the app was entered in a spreadsheet and compared to previous values from our center. Mean values were compared using the unpaired t test (2-tailed).Results: A total of 62 patients were thrombolysed during the time period using the mobile app. The mean DNT was 45 min with 89% being thrombolysed within 60 minutes and 57% being thrombolysed within 45 minutes.These patients were compared with 100 consecutive patients who were thrombolysed in the months prior to April 2017, where the mean DNT was 57 min, with 67% thrombolysed within 60 minutes and 47% being thrombolysed within 45 minutes.A mean DNT decrease of 12 minutes was seen with 1.3 x increase in DNT < 60 min. This difference was statistically significant (p¼0.0104, unpaired t test). The causes of delay were identified and included delays in patient shifting and imaging. Conclusions: We have been able to demonstrate significant improvement in doorto-needle time by using a mobile app as a tool to improve team performance; in addition, the app allowed us to identify causes of delay.

Hot Off the Press: Video for Acute Otitis Media Discharge Instructions

“…[11][12][13] Video discharge instructions have been shown to be preferred over paper instructions in many pediatric presentations; however, no study has explored the effectiveness of video instructions for AOM. 14,15…”

Video Discharge Instructions for Acute Otitis Media in Children: A Randomized Controlled Open‐label Trial

“…Standardized discharge instructions are preferred to verbal summaries by parents, are associated with decreased medication error rates, and may be facilitated by video technology. Video technology has been used in pediatric lacerations, sprains, fever, and head injury and is preferred over paper instructions . However, no study has explored the effectiveness of video technology for discharge instruction in AOM.…”