Codesign of health technology interventions to support best-practice perioperative care and surgical waitlist management

Sarah Joy Aitken, Sophie James, Amy Lawrence,Anthony Glover,Henry Pleass, Janani Thillianadesan,Sue Monaro,Kerry Hitos,Vasi Naganathan

BMJ HEALTH & CARE INFORMATICS(2024)

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摘要
Objectives This project aimed to determine where health technology can support best-practice perioperative care for patients waiting for surgery.Methods An exploratory codesign process used personas and journey mapping in three interprofessional workshops to identify key challenges in perioperative care across four health districts in Sydney, Australia. Through participatory methodology, the research inquiry directly involved perioperative clinicians. In three facilitated workshops, clinician and patient participants codesigned potential digital interventions to support perioperative pathways. Workshop output was coded and thematically analysed, using design principles.Results Codesign workshops, involving 51 participants, were conducted October to November 2022. Participants designed seven patient personas, with consumer representatives confirming acceptability and diversity. Interprofessional team members and consumers mapped key clinical moments, feelings and barriers for each persona during a hypothetical perioperative journey. Six key themes were identified: 'preventative care', 'personalised care', 'integrated communication', 'shared decision-making', 'care transitions' and 'partnership'. Twenty potential solutions were proposed, with top priorities a digital dashboard and virtual care coordination.Discussion Our findings emphasise the importance of interprofessional collaboration, patient and family engagement and supporting health technology infrastructure. Through user-based codesign, participants identified potential opportunities where health technology could improve system efficiencies and enhance care quality for patients waiting for surgical procedures. The codesign approach embedded users in the development of locally-driven, contextually oriented policies to address current perioperative service challenges, such as prolonged waiting times and care fragmentation.Conclusion Health technology innovation provides opportunities to improve perioperative care and integrate clinical information. Future research will prototype priority solutions for further implementation and evaluation.
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关键词
Medical Informatics,Patient-Centered Care,Health Services Research,Health Information Systems,General Surgery
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