Browsing by Author "Wu, Robert"
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- ItemDemonstrating the BlackBerry as a clinical communication tool: a pilot study conducted through the Centre for Innovation in Complex Care.(2008-12-11) Quan, Sherman; Wu, Robert; Morra, Dante; Wong, Brian M; Mraz, Richard; Hamill, Melinda; Abrams, Howard; Rossos, Peter GCanadians are living longer with chronic medical conditions which have led to an increasing complexity and volume of care for hospitalized patients Effective in patient care depends on the effective coordination of care through rapid and efficient communication between various care providers A delay in coordinating this care has downstream effects on other parts of the system ultimately contributing to increased emergency department wait times To address this system wide issue the Centre for Innovation in Complex Care at the University Health Network collaborated with Sunnybrook Health Sciences Centre to pilot the use of BlackBerry devices on the general internal medicine wards to improve clinical communication We describe the implementation process impact on clinical care and lessons learned from this experience We observed that residents quickly adopted this new technology and felt that it improved their workflow efficiency and productivity
- ItemAn evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study.(2011-08-30) Wu, Robert; Rossos, Peter; Quan, Sherman; Reeves, Scott; Lo, Vivian; Wong, Brian; Cheung, Mark; Morra, DanteBACKGROUND Communication between clinicians is critical to providing quality patient care but is often hampered by limitations of current systems Smartphones such as BlackBerrys may improve communication but studies of these technologies have been limited to date OBJECTIVE Our objectives were to describe how smartphones were adopted for clinical communication within general internal medical wards and determine their impact on team effectiveness and communication METHODS This was a mixed methods study that gathered data from the frequency of smartphone calls and email messages clinicians interviews and ethnographic observations of clinical communication interactions Triangulation of qualitative and quantitative data was undertaken to develop common themes that encompass comprehensive and representative insights across different methods RESULTS Findings from our study indicated that over a 24 hour period nurses sent on average 22 3 emails to the physicians mostly through the team smartphone the designated primary point of contact for a specific medical team Physicians carrying the team smartphone received on average 21 9 emails and 6 4 telephone calls while sending out 6 9 emails and initiating 8 3 telephone calls over the 24 hour period Our analyses identified both positive and negative outcomes associated with the use of smartphones for clinical communication There was a perceived improvement in efficiency over the use of pagers for clinical communication for physicians nurses and allied health professionals In particular residents found that the use of smartphones helped to increase their mobility and multitasking abilities Negative outcomes included frequent interruptions and discordance between what doctors and nurses considered urgent Nurses perceived a worsening of the interprofessional relationships due to overreliance on messaging by text with a resulting decrease in verbal communication Unprofessional behaviors were observed in the use of smartphones by residents CONCLUSIONS Routine adoption of smartphones by residents appeared to improve efficiency over the use of pagers for physicians nurses and allied health professionals This was balanced by negative communication issues of increased interruptions a gap in perceived urgency weakened interprofessional relationships and unprofessional behavior Further communication interventions are required that balance efficiency and interruptions while maintaining or even improving interprofessional relationships and professionalism
- ItemFeasibility of Using a Smartwatch to Intensively Monitor Patients With Chronic Obstructive Pulmonary Disease: Prospective Cohort Study.(0000-00-00) Wu, Robert; Liaqat, Daniyal; de Lara, Eyal; Son, Tatiana; Rudzicz, Frank; Alshaer, Hisham; Abed-Esfahani, Pegah; Gershon, Andrea SBACKGROUND Acute exacerbations of chronic obstructive pulmonary disease COPD are associated with accelerated decline in lung function diminished quality of life and higher mortality Proactively monitoring patients for early signs of an exacerbation and treating them early could prevent these outcomes The emergence of affordable wearable technology allows for nearly continuous monitoring of heart rate and physical activity as well as recording of audio which can detect features such as coughing These signals may be able to be used with predictive analytics to detect early exacerbations Prior to full development however it is important to determine the feasibility of using wearable devices such as smartwatches to intensively monitor patients with COPD OBJECTIVE We conducted a feasibility study to determine if patients with COPD would wear and maintain a smartwatch consistently and whether they would reliably collect and transmit sensor data METHODS Patients with COPD were recruited from 3 hospitals and were provided with a smartwatch that recorded audio heart rate and accelerations They were asked to wear and charge it daily for 90 days They were also asked to complete a daily symptom diary At the end of the study period participants were asked what would motivate them to regularly use a wearable for monitoring of their COPD RESULTS Of 28 patients enrolled 16 participants completed the full 90 days The average age of participants was 68 5 years and 36 10 28 were women Survey heart rate and activity data were available for an average of 64 5 65 1 and 60 2 days respectively Technical issues caused heart rate and activity data to be unavailable for approximately 13 and 17 days respectively Feedback provided by participants indicated that they wanted to actively engage with the smartwatch and receive feedback about their activity heart rate and how to better manage their COPD CONCLUSIONS Some patients with COPD will wear and maintain smartwatches that passively monitor audio heart rate and physical activity and wearables were able to reliably capture near continuous patient data Further work is necessary to increase acceptability and improve the patient experience
- ItemShort message service or disService: issues with text messaging in a complex medical environment.(2014-03-03) Wu, Robert; Appel, Lora; Morra, Dante; Lo, Vivian; Kitto, Simon; Quan, ShermanHospitals today are experiencing major changes in their clinical communication workflows as conventional numeric paging and face to face verbal conversations are being replaced by computer mediated communication systems In this paper we highlight the importance of understanding this transition and discuss some of the impacts that may emerge when verbal clinical conversations are replaced by short text messages