Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams

Maximilian J Johnston; Dominic King; Sonal Arora; Nebil Behar; Thanos Athanasiou; Nick Sevdalis; Ara Darzi

doi:10.1016/j.amjsurg.2014.08.030

Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams

Am J Surg. 2015 Jan;209(1):45-51. doi: 10.1016/j.amjsurg.2014.08.030. Epub 2014 Oct 22.

Authors

Maximilian J Johnston¹, Dominic King², Sonal Arora³, Nebil Behar⁴, Thanos Athanasiou⁵, Nick Sevdalis³, Ara Darzi⁵

Affiliations

¹ Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK. Electronic address: m.johnston@imperial.ac.uk.
² Centre for Health Policy, Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
³ Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
⁴ Department of Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
⁵ Department of Surgery and Cancer, Imperial College London, London, UK.

PMID: 25454952
DOI: 10.1016/j.amjsurg.2014.08.030

Abstract

Background: Outdated communication technologies in healthcare can place patient safety at risk. This study aimed to evaluate implementation of the WhatsApp messaging service within emergency surgical teams.

Methods: A prospective mixed-methods study was conducted in a London hospital. All emergency surgery team members (n = 40) used WhatsApp for communication for 19 weeks. The initiator and receiver of communication were compared for response times and communication types. Safety events were reported using direct quotations.

Results: More than 1,100 hours of communication pertaining to 636 patients were recorded, generating 1,495 communication events. The attending initiated the most instruction-giving communication, whereas interns asked the most clinical questions (P < .001). The resident was the speediest responder to communication compared to the intern and attending (P < .001). The participants felt that WhatsApp helped flatten the hierarchy within the team.

Conclusions: WhatsApp represents a safe, efficient communication technology. This study lays the foundations for quality improvement innovations delivered over smartphones.

Keywords: Communication; Information technology; Patient safety; Surgery; mHealth.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cell Phone*
Emergency Medical Services / organization & administration*
General Surgery / organization & administration*
Humans
Interprofessional Relations*
Mobile Applications*
Patient Care Team / organization & administration*
Patient Safety*
Prospective Studies
Time Factors