A smartphone app designed to empower patients to contribute toward safer surgical care: Qualitative evaluation of diverse public and patient perceptions using focus groups

TY - JOUR

T1 - A smartphone app designed to empower patients to contribute toward safer surgical care

T2 - Qualitative evaluation of diverse public and patient perceptions using focus groups

AU - Russ, Stephanie

AU - Sevdalis, Nick

AU - Ocloo, Josephine

N1 - Funding Information: The authors would like to acknowledge the valued contributions made by all members of the focus groups and the time they committed to the project. SR, JO, and NS were supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (ARC South London) at the King’s College Hospital NHS Foundation Trust. SR (creator of MySurgery) is supported by the NIHR through a Knowledge Mobilization Fellowship to evaluate the MySurgery app over a 3-year program. JO was supported by the Health Foundation through an Improvement Science Fellowship. NS is a member of King’s Improvement Science, which is part of the NIHR ARC South London and comprises a specialist team of improvement scientists and senior researchers based at the King’s College London. Its work was funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London, and South London and Maudsley NHS Foundation Trust), Guy’s and St Thomas’ Charity, the Maudsley Charity, and the Health Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Funding Information: The authors would like to acknowledge the valued contributions made by all members of the focus groups and the time they committed to the project. SR, JO, and NS were supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (ARC South London) at the King's College Hospital NHS Foundation Trust. SR (creator of MySurgery) is supported by the NIHR through a Knowledge Mobilization Fellowship to evaluate the MySurgery app over a 3-year program. JO was supported by the Health Foundation through an Improvement Science Fellowship. NS is a member of King's Improvement Science, which is part of the NIHR ARC South London and comprises a specialist team of improvement scientists and senior researchers based at the King's College London. Its work was funded by King's Health Partners (Guy's and St Thomas'NHS Foundation Trust, King's College Hospital NHS Foundation Trust, King's College London, and South London and Maudsley NHS Foundation Trust), Guy's and St Thomas' Charity, the Maudsley Charity, and the Health Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Publisher Copyright: © 2021 Stephanie Russ, Nick Sevdalis, Josephine Ocloo. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/4

Y1 - 2021/4

N2 - Background: MySurgery is a smartphone app designed to empower patients and their caregivers to contribute toward safer surgical care by following practical advice to help reduce susceptibility to errors and complications. Objective: The aim of this study is to evaluate service users' perceptions of MySurgery, including its perceived acceptability, the potential barriers and facilitators to accessing and using its content, and ideas about how to facilitate its effective implementation. The secondary aim is to analyze how the intended use of the app might differ for diverse patients, including seldom-heard groups. Methods: We implemented a diversity approach to recruit participants from a range of backgrounds with previous experience of surgery. We aimed to achieve representation from seldom-heard groups, including those from a Black, Asian, and minority ethnic (BAME) background; those with a disability; and those from the lesbian, gay, bisexual, transgender, queer (LGBT+) community. A total of 3 focus groups were conducted across a 2-month period, during which a semistructured protocol was followed to elicit a rich discussion around the app. The focus groups were audio recorded, and thematic analysis was carried out. Results: In total, 22 individuals participated in the focus groups. A total of 50% (n=11) of the participants were from a BAME background, 59% (n=13) had a disability, and 36% (n=8) were from the LGBT+ community. There was a strong degree of support for the MySurgery app. The majority of participants agreed that it was acceptable and appropriate in terms of content and usability, and that it would help to educate patients about how to become involved in improving safety. The checklist-like format was popular. There was rich discussion around the accessibility and inclusivity of MySurgery. Specific user groups were identified who might face barriers in accessing the app or acting on its advice, such as those with visual impairments or learning difficulties and those who preferred to take a more passive role (eg, some individuals because of their cultural background or personality type). The app could be improved by signposting further specialty-specific information and incorporating a calendar and notes section. With regard to implementation, it was agreed that use of the app should be signposted before the preoperative appointment and that training and education should be provided for clinicians to increase awareness and buy-in. Communication about the app should clarify its scientific basis in plain English and should stress that its use is optional. Conclusions: MySurgery was endorsed as a powerful tool for enhancing patient empowerment and facilitating the direct involvement of patients and their caregivers in maintaining patient safety. The diversity approach allowed for a better understanding of the needs of different population groups and highlighted opportunities for increasing accessibility and involvement in the app.

AB - Background: MySurgery is a smartphone app designed to empower patients and their caregivers to contribute toward safer surgical care by following practical advice to help reduce susceptibility to errors and complications. Objective: The aim of this study is to evaluate service users' perceptions of MySurgery, including its perceived acceptability, the potential barriers and facilitators to accessing and using its content, and ideas about how to facilitate its effective implementation. The secondary aim is to analyze how the intended use of the app might differ for diverse patients, including seldom-heard groups. Methods: We implemented a diversity approach to recruit participants from a range of backgrounds with previous experience of surgery. We aimed to achieve representation from seldom-heard groups, including those from a Black, Asian, and minority ethnic (BAME) background; those with a disability; and those from the lesbian, gay, bisexual, transgender, queer (LGBT+) community. A total of 3 focus groups were conducted across a 2-month period, during which a semistructured protocol was followed to elicit a rich discussion around the app. The focus groups were audio recorded, and thematic analysis was carried out. Results: In total, 22 individuals participated in the focus groups. A total of 50% (n=11) of the participants were from a BAME background, 59% (n=13) had a disability, and 36% (n=8) were from the LGBT+ community. There was a strong degree of support for the MySurgery app. The majority of participants agreed that it was acceptable and appropriate in terms of content and usability, and that it would help to educate patients about how to become involved in improving safety. The checklist-like format was popular. There was rich discussion around the accessibility and inclusivity of MySurgery. Specific user groups were identified who might face barriers in accessing the app or acting on its advice, such as those with visual impairments or learning difficulties and those who preferred to take a more passive role (eg, some individuals because of their cultural background or personality type). The app could be improved by signposting further specialty-specific information and incorporating a calendar and notes section. With regard to implementation, it was agreed that use of the app should be signposted before the preoperative appointment and that training and education should be provided for clinicians to increase awareness and buy-in. Communication about the app should clarify its scientific basis in plain English and should stress that its use is optional. Conclusions: MySurgery was endorsed as a powerful tool for enhancing patient empowerment and facilitating the direct involvement of patients and their caregivers in maintaining patient safety. The diversity approach allowed for a better understanding of the needs of different population groups and highlighted opportunities for increasing accessibility and involvement in the app.

KW - Mobile health

KW - Mobile phone

KW - Patient involvement

KW - Patient safety

KW - Perioperative care

KW - Smartphone app

UR - http://www.scopus.com/inward/record.url?scp=85104099748&partnerID=8YFLogxK

U2 - 10.2196/24065

DO - 10.2196/24065

M3 - Article

C2 - 33830062

AN - SCOPUS:85104099748

SN - 2291-5222

VL - 9

JO - JMIR mHealth and uHealth

JF - JMIR mHealth and uHealth

IS - 4

M1 - e24065

ER -