There is a high potential for mobile learning and support applications in the health domain. In this paper we introduce the CLAS App, a mobile application to support handover procedures based on the improvement of writing skills. Handover of patient care is a time of particular risk and it is important that accurate, reliable and relevant information is clearly communicated between one caregiver to another. Improperly conducted handovers lead to wrong treatment, delays in medical diagnosis, life threatening adverse events, patient complaints, medical litigation, increased health care expenditure, increased hospital length of stay and a range of other effects that impact on the health system. The CLAS App helps standardise and improve handover communication between hospital and community healthcare.
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1. The CLAS AppA mobile training tool to improve handover
procedures between hospital interface and family doctors Simple
mobile innovations 1
2. What is a HANDOVER?
3. What is a HANDOVER?
4. What is a HANDOVER?Shorter hospitalizations, more frequent
patient transitions high demands on the quality of clinical
handovers
5. The ProblemIn many cases of avoidable maternaldeath
identified in the UK ConfidentialEnquiry, care was hampered by a
lack ofcross-disciplinary or cross-agencycooperation and
communicationproblems, ...WHO Patient Safety Curriculum Guide, 2011
4
6. Discharge summaries often did not ... Share Information with
patients 91% Tests pending at discharge 65% Diagnostic Test Results
38% Identified Hospital Dr 25% Treatment/hospital course 22%
Discharge medications 21% Main diagnosis 18% Follow-up plans 14%
Physical Findings 11%Kripalani et al., (2007) Deficits in
Communication and Information Transfer BetweenHospital-Based and
Primary Care Physicians. Implications for Patient Safety
andContinuity of Care. JAMA. 2007;297(8) 831-841. 5
7. WHO High 5 Patient SafetyThe World Health Organization (WHO)
listsaccurate handovers as one of its High 5Patient Safety
initiatives.Training of handover skills would appear to bea
promising approach to improve the qualityof patient continue
care.WHO Patient Safety Curriculum Guide.Published October 2011.
6
8. Related mobile health projects
9. Related mobile health projects
10. Process mapping
11. Process mapping
12. Process mapping Handover info
13. Challenge 1: Information Quality 30
14. Challenge 2: Access 30
15. Challenge 3: Standardize General Name Address MRN DOB
Hospital Ward Consultant Speciality Date admission Date of
discharge GPs name 30
16. The Cork Letter-WritingAssessment Skills (CLAS) 13
17. The CLAS App
18. The CLAS App
19. Pilot study at UCC 80 m 80 medical students (4th yr) Patie
given teach Patient casenotes (fictional) given 40 st to students
in advance of on th teaching session write (25 m Experimental group
(n=40) students received instruction on Cont disch the CLAS scale.
Asked to write a patient discharge letter (25 instr mins) Control
group (n=40) wrote discharge letter without CLAS instruction
15
20. Pilot study at UCCMaher, B., Henn, P., Gaffney, R. (2012).
Teaching medical students How to Write PatientDischarge Letters
Development of an i-Phone application. AMEE conference 2012,Lyon,
France. 16
21. Challenge to prove that mobile educational interventions
improve handover Lack of research describing / assessment of
educational interventions to improve handover. Transfer of skills
to workplace - some evidence Improved Patient Safety - no evidence
Gordon M, Findley R. Educational interventions to improve handover
in health care: a systematic review. MEDICAL EDUCATION 2011; 45:
10811089 17
22. Conclusions1.Use of checklists can improve the overall
quality, content, structure and clarity of hospital discharge
letters written by medical students.2.Medical students benefit from
formal instruction in letter-writing skills.3.Use of the CLAS app
at point of practice may improve the quality of hospital discharge
letters. 18
23. Future Research and Development Extending the idea of apps
tosupport handover processes(communication, awareness,reflection
competences). Extending the handover appapproach to empower
patients NFC Linked Data (ICD9, SNOMED_CT) 19
24. Future Research and Development Extending the idea of apps
tosupport handover processes(communication, awareness,reflection
competences). Extending the handover appapproach to empower
patients NFC Linked Data (ICD9, SNOMED_CT) 19
25. Future Research and Development1. Analysis of 200 hospital
discharge letters from 5different GP practices using CLAS scale2.
Extending the handover app approach to empowerpatients3. Pilot
phase for CLAS and other mobile apps in thePATIENT project ->
TARGET: train 600 students peryear with mobile learning tools for
handover 20
26. Thank you for attending this lecture!This silde is
available at:http://www.slideshare.com/DrachslerEmail:
[email protected]: celstec-hendrik.drachslerBlogging at:
http://www.drachsler.deTwittering at:
http://twitter.com/HDrachslerLinks: patient-project.eu
handovertoolbox.eu 21