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      A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Community-Based Evaluation Using a Participatory Approach

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          Abstract

          Background

          MySurgery is a smartphone app designed to increase patient and carer involvement in behaviors that contribute toward safety in surgical care.

          Objective

          This study presents a pilot evaluation of MySurgery in which we evaluated surgical patients’ perceptions of the app in terms of its content, usability, and potential impacts on communication and safety.

          Methods

          A participatory action research (PAR) approach was used to formulate a research steering group consisting of 5 public representatives and 4 researchers with equal decision-making input. Surgical patients were recruited from the community using multiple approaches, including Web based (eg, social media, recruitment websites, and charitable or voluntary organizations) and face to face (via community centers). Participants referred to MySurgery before, during, and after their surgery and provided feedback via an embedded questionnaire and using reflective notes.

          Results

          A diverse mix of 42 patients took part with good representation from 2 “seldom heard” groups: those with a disability and those from a black, Asian, or minority ethnic group. Most were very supportive of MySurgery, particularly those with previous experience of surgery and those who felt comfortable to be involved in conversations and decisions around their care. The app showed particular potential to empower patients to become involved in their care conversations and safety-related behaviors. Perceptions did not differ according to age, ethnicity, or length of hospital stay. Suggestions for improving the app included how to make it more accessible to certain groups, for example, those with a disability.

          Conclusions

          MySurgery is a novel technology-driven approach for empowering patients to play a role in improving surgical safety that seems feasible for use within the United Kingdom’s National Health Service. Adopting a PAR approach and the use of a diversity strategy considerably enhanced the research process in terms of gaining diverse participant recruitment and patient and public involvement. Further testing with stakeholder groups will follow.

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          Most cited references10

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          Black and minority ethnic group involvement in health and social care research: A systematic review

          Abstract Background Patient and public involvement (PPI) in research is growing internationally, but little is known about black and minority ethnic (BME) involvement and the factors influencing their involvement in health and social care research. Objectives To characterize and critique the empirical literature on BME‐PPI involvement in health and social care research. Search strategy Systematic searches of six electronic bibliographic databases were undertaken, utilizing both MeSH and free‐text terms to identify international empirical literature published between 1990 and 2016. Inclusion criteria All study designs that report primary data that involved BME groups in health or social care research. Screening was conducted by two reviewers. Data extraction and synthesis Data extraction and quality appraisal were performed independently. Data extraction focused on the level(s) of PPI involvement and where PPI activity occurred in the research cycle. Studies were quality‐assessed using the guidelines for measuring the quality and impact of user involvement in research. Data were analysed using a narrative approach. Main results Forty‐five studies were included with the majority undertaken in the USA focusing on African Americans and indigenous populations. Involvement most commonly occurred during the research design phase and least in data analysis and interpretation. Conclusion This is the first systematic review investigating BME involvement in health and social care research internationally. While there is a widespread support for BME involvement, this is limited to particular phases of the research and particular ethnic subgroups. There is a need to understand factors that influence BME involvement in all parts of the research cycle.
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            How technology is empowering patients? A literature review.

            The term 'Patient Empowerment' (PE) is a growing concept – so in popularity as in application – covering situations where citizens are encouraged to take an active role in the management of their own health. This concept is serving as engine power for increasing the quality of health systems, but a question is still unanswered, 'how PE will be effectively achieved?' Beyond psychological implications, empowerment of patients in daily practice relies on technology and the way it is used. Unfortunately, the heterogeneity of approaches and technologies makes difficult to have a global vision of how PE is being performed.
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              The Irish National Adverse Events Study (INAES): the frequency and nature of adverse events in Irish hospitals—a retrospective record review study

              Introduction Irish healthcare has undergone extensive change recently with spending cuts and a focus on quality initiatives; however, little is known about adverse event occurrence. Objective To assess the frequency and nature of adverse events in Irish hospitals. Methods 1574 (53% women, mean age 54 years) randomly selected adult inpatient admissions from a sample of eight hospitals, stratified by region and size, across the Republic of Ireland in 2009 were reviewed using two-stage (nurse review of patient charts, followed by physician review of triggered charts) retrospective chart review with electronic data capture. Results were weighted to reflect the sampling strategy. The impact on adverse event rate of differing application of international adverse event criteria was also examined. Results 45% of charts were triggered. The prevalence of adverse events in admissions was 12.2% (95% CI 9.5% to 15.5%), with an incidence of 10.3 events per 100 admissions (95% CI 7.5 to 13.1). Over 70% of events were considered preventable. Two-thirds were rated as having a mild-to-moderate impact on the patient, 9.9% causing permanent impairment and 6.7% contributing to death. A mean of 6.1 added bed days was attributed to events, representing an expenditure of €5550 per event. The adverse event rate varied substantially (8.6%–17.0%) when applying different published adverse event eligibility criteria. Conclusions This first study of adverse events in Ireland reports similar rates to other countries. In a time of austerity, adverse events in adult inpatients were estimated to cost over €194 million. These results provide important baseline data on the adverse event burden and, alongside web-based chart review, provide an incentive and methodology to monitor future patient-safety initiatives.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                January 2020
                20 January 2020
                : 8
                : 1
                : e12859
                Affiliations
                [1 ] King's College London London United Kingdom
                Author notes
                Corresponding Author: Stephanie Russ stephanie.russ@ 123456kcl.ac.uk
                Author information
                https://orcid.org/0000-0002-4264-2453
                https://orcid.org/0000-0002-0137-8940
                https://orcid.org/0000-0001-7799-6465
                https://orcid.org/0000-0002-0079-5697
                https://orcid.org/0000-0001-5656-8904
                https://orcid.org/0000-0002-4702-7687
                https://orcid.org/0000-0001-7560-8924
                https://orcid.org/0000-0003-0027-9091
                Article
                v8i1e12859
                10.2196/12859
                6997920
                31958067
                91a44f7a-84b8-4cc4-bdec-7b7f540202c2
                ©Stephanie Russ, Zahira Latif, Ahmarah Leah Hazell, Helen Ogunmuyiwa, Josephine Tapper, Sylvia Wachuku-King, Nick Sevdalis, Josephine Ocloo. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 20.01.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 20 November 2018
                : 31 March 2019
                : 26 August 2019
                : 26 September 2019
                Categories
                Original Paper
                Original Paper

                patient safety,surgery,smartphone,mobile phone,patient empowerment

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