PatientLink: a patient-centred status dashboard for the perioperative process

Abstract

© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Surgery is stressful. According to the National Center for Health Statistics, 48 million surgical procedures were performed in the USA in a single year. The majority of these procedures reflect instances wherein patients are entering an unfamiliar, foreign environment for the first time. While it is common practice for patients to have family or friends accompany them on the day of their surgery, the clinical world is unfamiliar to those outside the healthcare profession. This is true during the perioperative process, a period of time where supporters are separated from their loved ones. Despite the fact that surgeons agree perioperative communication with family members plays a key role in alleviating anxiety and providing support, there remains inconsistent communication in terms of frequency and content. The need for improved communication between the healthcare team and supporters is recognised across multiple disciplines. 4 There is a noted lack of consistency in the frequency and content of communication in clinical practice. A recent systematic review indicated that improved communication throughout the perioperative process is a wellrecognised need for patient and supporter satisfaction. Currently, the literature focuses on preoperative anxiety among patients themselves, including success of operation, complications, postoperative pain and recovery timeline. 6 It is also recognised that the hospital environment proves stressful to not only the patient, but their supporters as well. Furthermore, the emotional status of supporters can impact a patient’s response and recovery, such as in settings where they are the main representative of the patient. However, limited research on the specific sources of stress for supporters has been conducted. Additionally, existing solutions for improved communication between the healthcare team and patient supporters are lacking. These solutions have covered a spectrum of fidelity. Low fidelity options include inperson reports, pagers and shortmessaging services (SMS otherwise known as ‘texting’). The use of pagers with EMRintegrated text communication capabilities, much like those used by hospital staff, was found to improve both workplace efficiency and satisfaction among families, nurses and surgeons alike. Additional low fidelity interventions include educational strategies in the form of informational cards and booklets outlining the procedural details, expected duration and perioperative process. 13 While promising, these strain hospital staff workflow to provide frequent updates, Summary box