Web-based toolkits used by patients and/or their healthcare providers in the hospital setting have the potential to increase patient engagement and improve communication with clinicians, according a new study led by researchers at Boston-based Brigham and Women's Hospital (BWH).
The research study, “Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication, and Technology (PROSPECT),” provided patients and their caregivers with iPads on which they could access novel tools to participate in their plan of care during hospitalization. The study, which was published in the Journal of the American Medical Informatics Association and appeared online August 3, was conducted in the medical intensive care and oncology units at BWH.
The patient-centered toolkit (PCTK) provided access to educational content specific to a patient's condition and facilitated patient-provider communication using a novel messaging platform integrated into providers' workflow. In this study, researchers evaluated their enrollment strategy, use and usability of patient tools, and the content of patient-generated messages.
Specifically, researchers report that non-critically ill oncology patients were more likely to engage with the PCTK compared with critically-ill medical intensive care unit (MICU) patients. However, caregivers of critically-ill MICU patients often used the PCTK on the patient's behalf. They learned that patients and caregivers most often used the PCTK to establish goals, view test results and medications, and identify care team members. Additionally, patients and caregivers used the messaging functionality primarily to report health concerns, needs, or preferences, but did not overwhelm providers with too many messages or demand immediate responses, the study found.
"Doctors and nurses oversee the plan of care, but the patients' goals, priorities, and preferences may not always be effectively conveyed to the clinical care team,” said lead author Anuj Dalal, M.D., and a hospitalist in BWH's Division of General Medicine and Primary Care. “Decision-making should be shared among patients, families and healthcare providers. We found that this tool widened communication, helping patients and family members partner with healthcare providers to improve the quality and safety of their care.”