Working across different clinical and non-clinical disciplines, paediatric nurses and a paediatric consultant collaborated with the patient experience team at Walsall Healthcare NHS Trust to lead on the development and implementation of a children’s health smartphone application (App) for staff, patients, their families and carers. This has significantly improved patient, carer and family experience as well as better use of resources locally.
Where to look
The paediatric team identified when shadowing patients on the children’s ward that at times parents and carers expressed worry or confusion due to not having the right information available to them at a time it was needed most. The nurses identified unwarranted variation in the use of information on the Trust’s website, as well as in the knowledge of families as to where to find the information to prepare them for their stay on the ward.
What to change
Feedback was gathered from ward staff caring for patients and their families, as well as from patients and families themselves. This demonstrated that often there was a lack of knowledge of the hospitals processes, which made them feel disempowered, and there were gaps in the information available about hospital visits, procedures and investigations via the resources they were using. Feedback indicated that it was difficult to find information on the Trust’s website, it was not always up-to-date and the website did not work well on different mobile devices. It was identified that patients and families wanted to see information prior to their visit, whilst they were in the hospital and afterwards when discharged home.
The paediatric team identified that a digital application was the most suitable, secure solution to address the unwarranted variation seen in practice and was a cost and resource effective solution, which could be free and easily accessible to patients and families whilst providing information to improve their experience of the department and hospital.
How to change
The app was created using in-house resources and readily available web tools. The nursing and clinical team worked collaboratively with the Patient Experience team to use feedback from patients, carers, families and staff both from the ward and more widely to ensure the finished App met a range of needs of patients and staff. The ward play specialists supported children visiting the ward to engage with the programme and give their thoughts and feedback on the programme as it developed. Developing the content in consultation with these groups ensured that the App was fit for purpose and user friendly. For instance, the children and young people’s section was developed following a focus group and user testing.
The final digital product is a is a single ‘go to’ App for patients and staff that is feature-rich including:
- Introduction to the paediatric healthcare team with their photographs and role descriptions;
- Information about procedures and investigations that may be conducted in the department;
- Frequently Asked Questions (FAQs) section;
- ‘Looking after my child’ video clips, which include how young children can control their asthma, what happens when a child has a CT scan or an x-ray;
- The Children’s Ward can be telephoned directly through the App;
- Games and distraction tools for procedures;
- Links to local and national health news;
- Patient experience and feedback systems;
- Facilities to manage, cancel and reschedule appointments;
- Way-finding and available hospital facilities;
- The App also has a dedicated staff area which is password protected and includes:
- Resources such as clinical guidelines, education opportunities and teaching timetables;
- Updates and useful information;
- Quality Improvement tips and tools.
Following its development, the nursing team with senior clinical engagement played a key role in embedding the App into practice, promoting it and ensuring patients, staff and others using the App understood it and used it effectively. A communications plan was developed to promote the App via social media and supported the development of an awareness video. Promotional posters and flyers were created with input from patients, families and carers, which detailed how to access free-Wi-Fi across the hospital to enable the App to be used and a Quick Response (QR) code supported users in finding the App via mobile devices.
The App is centrally managed by the nursing and patient experience team to ensure it is kept up-to-date and continues to evolve as team members provide additional information and user feedback is responded to.
Better outcomes – The App whilst not directly evaluated for its effect on outcomes has anecdotally had a positive impact for patients, families and carers. It supports children and their families to prepare adequately for their visit and manage their appointments effectively. Children using services are now better informed earlier in their care.
Better experience – The team conducted a user survey for those using the App with results demonstrating that one hundred percent of patients/families found the App easy to use and liked the appearance. Ninety percent of those surveyed also reported they felt the App had all the information they needed. The App has been well received with over ten thousand views and this continues to increase. Patients on the ward report feeling better prepared having watched the App videos for what may otherwise be frightening tests. Following a Magnetic Resonance Imaging (MRI) brain scan a child reported ‘That was easy!”
Better use of resources – The introduction of password protected areas for staff, including guidelines and teaching timetables, has been well received as they are using the App daily on the unit and it is part of ward orientation. This has kept the App fresh and in the forefront of people’s mind so it is promoted to families and children. Staff can quickly access guidance if required, which has saved time.
Challenges and lessons learnt for implementation
- Listening to patients, their families and carers is key as in this case the idea of a digital App came from a patient. Feedback continues to support the team to evolve the app ensuring it remains fit-for-purpose and useful;
- Quality improvement doesn’t have to be costly, utilising internal resources and expertise has been key to success and easily available web tools were used to create the app with minimal start-up cost;
- Using an agile web-based App platform means that changes can be made easily, in real time and are easily communicated with those using the App.
The App was overall winner at the Patient Experience Network National Awards (PENNA) in 2017 and has inspired other teams in the Trust to consider implementing creative ideas in their departments. Pages are being added to the App for other departments that have input into children’s care such as surgery, radiology, pharmacy and community paediatrics.
Find out more
For more information contact:
- Kuldeep Singh, Patient Experience Manager, Walsall Healthcare NHS Trust, firstname.lastname@example.org