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What can a mobile App add to improve quality of care, with focus on ambulatory surgery?

Metha Brattwall, Magareta Warrén Stomberg, Pether Jildenstål, Irene Sellbrandt, Jan G Jakobsson


Rationale, aims and objectives: Many surgical procedures are nowadays performed as ambulatory or short stay procedures, reducing hospital length of stay. Patient safety and quality of care remain imperative especially when adopting enhanced recovery pathways. Patients should be adequately informed and prepared prior to admission. Recovery is to a major extent dependent after discharge on self-care and thus techniques to follow the post-operative course after leaving hospital are warranted. Telemedicine has grown tremendously over recent years and the incorporation of mobile telephone app technology for the pre- and post-operative coaching of the ambulatory surgical patient may represent an effective means of assisting patients. The present paper presents a feasibility study of a mobile telephone app providing pre-operative information and following the post-operative recovery following day surgery.

Method: Patients scheduled for elective day surgery were asked to participate, testing the app and to assess its usefulness on visual analogue scales.

Results: Sixty-nine patients aged 18 to 73 years tested the app. Patients aged 30 to 50 where the most frequent users and patients < 30 less frequent. The app was in general assessed as useful and most users expressed an interest in the option of having an app as a source of information before undergoing a scheduled procedure. General pre-operative information was assessed as the most important. A willingness to submit follow-up information decreased rapidly, only 26 and 16 responded at day 10 and 30, respectively.

Conclusion: A mobile telephone app is a feasible and appreciated tool for pre-operative information and coaching as part of person-centered healthcare, but its use for follow-up after discharge is challenging and requires further investigation.


Day surgery, mobile app, person-centered healthcare, quality of care, telemedicine

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Winther, S.B., Foss, O.A., Wik, T.S., Davis, S.P., Engdal, M., Jessen, V. & Husby, O.S. (2015). 1-year follow-up of 920 hip and knee arthroplasty patients after implementing fast-track. Acta Orthopaedica 86 (1) 78-85.

Kehlet, H. (2013). Fast-track hip and knee arthroplasty. Lancet 381 (9878) 1600-1602.

Whittaker, R. (2012). Issues in mHealth: findings from key informant interviews. Journal of Medical Internet Research 14 (5) e129.

Vesterby, M.S., Pedersen, P.U., Laursen, M., Mikkelsen, S., Larsen, J., Søballe, K. & Jøgensen, L.B. (2017). Telemedicine support shortens length of stay after fast-track hip replacement. Acta Orthopaedica 88 (1) 41-47.

Armstrong, K.A., Coyte, P.C., Bhatia, R.S. & Semple, J.L. (2015). The effect of mobile app home monitoring on number of in-person visits following ambulatory surgery: protocol for a randomized controlled trial. JMIR Research Protocols 4 (2) e65.

Warren-Stomberg, M., Jacobsson, J., Brattwall, M. & Jildenstal, P. (2016). At-home monitoring after surgery/anaesthesia - a challenge. Journal of Evaluation in Clinical Practice 22 (6) 882-886.

Nilsson, U., Jaensson, M., Dahlberg, K., Odencrants, S., Gronlund, A., Hagberg, L. & Eriksson, M. (2016). RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. BMJ Open 6 (1) e009901.

Chazapis, M., Walker, E.M., Rooms, M.A., Kamming, D. & Moonesinghe, S.R. (2016). Measuring quality of recovery-15 after day case surgery. British Journal of Anaesthesia 116 (2) 241-248.

Gunter, R,, Fernandes-Taylor, S., Mahnke, A., Awoyinka, L., Schroeder, C., Wiseman, J., Sullivan, S., Bennett, K., Greenberg, C. & Kent, K.C. (2016). Evaluating Patient Usability of an Image-Based Mobile Health Platform for Postoperative Wound Monitoring. JMIR mHealth and uHealth 4 (3) e113.

Puolakka, P.A., Rorarius, M.G., Roviola, M., Puolakka, T.J., Nordhausen, K. & Lindgren, L. (2010). Persistent pain following knee arthroplasty. European Journal of Anaesthesiology 27 (5) 455-460.

Mobasheri, M.H., Johnston, M., Syed, U.M., King, D. & Darzi, A. (2015). The uses of smartphones and tablet devices in surgery: A systematic review of the literature. Surgery 158 (5) 1352-1371.

NHS Choices Health Apps Library. Available at: Accessed 16th June 2017.



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