Nursing has a digital technology future [And here’s how Med App is helping now] 

Nursing and digital technology is one challenge the MedApps team has been working hard to solve in 2020 by taking lessons learned elsewhere in healthcare.

Med App was originally founded to support Doctors in Training, Locums and continuing education. It was built on the direct experience of navigating the challenges associated with starting in a new role at a new facility or new rotation. However, the technology’s application continues to find relevance for other health professionals.

Although Med App had demonstrated success for Doctors, we asked the question: Could Nursing benefit from surfacing critical information and streamlining administration associated with educating / engaging with team members? 

Throughout the later stages of 2019 and 2020, a large referral hospital, with around 1,300 Nurses took a step towards a digital technology future and agreed to pilot Med App with their Graduate Transition Program and across a busy ward. 

In this article, we share the lessons learned and Med App’s success from the pilot, and what’s next for Nurses ready to embrace a future with digital technology.

Nurses digital technology pilot to solve long standing challenges 

The thinking behind this pilot, which involved a Nursing staff of 66 (including 14 graduates) was to address long standing challenges, specifically around orientation, excessive paperwork and documentation, communication around countless clinical and organisational changes, administration of CPD, and general engagement / community and culture development.

In conjunction with the MedApp’s team, the pilot was designed to focus on key processes and content that would lead to increased engagement with Nurses by:

• Digitizing paper processes and communications for graduates
• Providing a digital orientation to the hospital, ward and graduate program
• Automating session and graduate program feedback
• Coordinating group education sessions
• Refining clinical and operational content that supports ongoing engagement.

Additionally, the pilot was to collate the most useful information from the many disparate systems where information was stored. By synthesizing what was stored on the intranet, USBs, LMS, and individual hard drives, the intent was to create a valuable and more easily accessible resource for Nursing staff, who had identified the priorities. Some examples are tabled below.

Ward-specific procedures	Unit information	Educational resources
‘How to’ guides (ABG interpretation, ECG review sheet, etc)Direct dial to avoid costly delays on switchQuick access to emergency and escalation numbers	Round timesAfter-hours team leader and AIN jobs listHandover, journey board, safety huddle standards and examples	Education plans, calendars and links to session notesAbility to communicate changes in session without emails or postersPatient diagnosis information sheets

What makes a great day? Outcomes from the Med App Nursing pilot

Prior to commencing the pilot, the MedApps team sought feedback from the team, which endorsed the decision by Nursing Executive Sponsor to invest in the project. When asked ‘What makes a great day?’, responses included:

• Accessible, necessary information at your hands to give great patient care.
• Structure, knowledge and skills.
• Having access to appropriate resources so we can best care for patients.

The project yielded encouraging outcomes that indicate the pilot Nursing app made solid inroads to satisfy user expectations.

Outcome	What it means
Annualised benefit for a full rollout projected to be around $500k of productive Nursing time	Meaningful time savings for individuals and facilitiesMore time to deliver quality patient care, learn or build culture
A time in motion evaluation indicated productive time benefits from 2.5 – 6 minutes minutes.	Time spent on Med App accessing relevant content saved significant time compared with the same task completed using existing processes
An average of 96 screen views per user for the trial period	Despite a standard culture of ‘not being able to use your phone on the floor’ average user per user remained consistent throughout the pilot period.
82 percent of users rated the Nursing app as ‘something they need’ or ‘definitely need’	A strong indicator in the merit of further nursing pilot projects

As with all pilot projects, there were lessons learned. However, that is the purpose of a pilot: gathering insights as to what can be taken forward and improved upon. Notably, the team found meaningful opportunities for further development.

• Develop a web based version of the app available on intranet that would provide workstation on wheels (WOW) access
• Automatically link to LMS modules for training delivered on the ward, which had the benefit of removing upwards of ~3-5 minutes per nurse per skill in Clinical Nurse Educator (CNE) administration
• Support mandatory training reminders and collation of completion 
• Reminders on content to be updated or relinked, for example, clinical business rules
• Automate certain workflows around communication and training evaluation, including reminders for reflections.

One of the most significant findings was around the quality and quantity of content shared with Nurses across different settings. This variation sparked an idea to develop Nursing rovers for the Transition Program participants. Essentially, this would be a rotation description written from the Graduate Nurse perspective. It would outline how things work and cover general operational information right through to management of typical patients and links to useful resources; essentially, everything a Graduate Nurse needs to be as effective as possible in this setting right from day one. 

Outcomes from this initial pilot have allowed Med App to be tested on a larger scale across the Local Health District Transition, Emerging Nurse Unit Manager, and Postgraduate specialist Programs. Going forward, there will be further experiments on how to best support established Nursing staff.

Where to next with the Nursing app?

Discussions with various Nurse Leaders and Managers identified a number of things to focus on for the upcoming Graduate Transition Program, scheduled for February 2021:

• The orientation schedule and tracking for Transitioning Program Nurses
• Integrating a schedule of 40 training sessions for the year into the app to provide nurses with visibility into training requirements
• Nurse ROVERs – key information for the unit written from the perspective of the clinician
• Critical clinical fact sheets and links to various resources. 
• COVID related materials – PPE, infection control, etc. 

While other areas have been identified for integration into the app, the urgency created by February’s new graduate arrivals, and the availability of ready content, has quarantined the project to this smaller scope.

The MedApps team is excited by the opportunity to continue its support of the hard working Nurses and Nurse Educators in 2021, and we’re looking forward to reporting how the project and app evolves when this next pilot is completed. 

Med App is an offline-accessible, mobile-first tool for easily accessing clinical and hospital guidelines, communicating with clinicians, and facilitating education and training, including for Nurses of all levels and experience. Med App’s usefulness to healthcare professionals at all levels is evident from the success experienced by over 20,000+ users worldwide. For more information, reach out by connecting with the team via email at [email protected], or uncover the possibilities when you book a complimentary Med App demonstration for your Nursing team.