Image-based digital post-discharge surveillance in England: measuring patient enrolment, engagement, clinician response times, surgical site infection, and carbon footprint

Rochon, M.; Jawarchan, A.; Fagan, F.; Otter, J.A.; Tanner, J.

Abstract

Background: Surgical site infections (SSIs) can have a significant impact on patients, their families and healthcare providers. With shortening inpatient periods, the post-discharge element of surveillance is becoming increasingly important. Proactive surveillance, including digital wound images using patient smartphones, may be an efficient alternative to traditional methods for collecting post-discharge surveillance (PDS). Aim: To determine success in patient enrolment and engagement including reasons for non-response, the time for clinicians to respond to patients, SSI rates, and carbon emissions when conducting PDS using patient smartphones. Methods: An evaluation was undertaken for a one-month period (June 2022) in two adult cardiac surgery services which routinely used patient smartphones for PDS, using the secure Islacare (Isla) system. Findings: The initial patient response rate for Isla was 87.3%, and the majority of patients (73%) remained engaged throughout the 30-day period. There was no significant difference in age, gender, operation type or distance to hospital between Isla responders or non-responders, or if the hospital provided a photo at discharge or not. Patients using Isla had a shorter post-discharge stay (P = 0.03), although this was not attributed to the platform. Patients not owning a smartphone and a technical issue were the main barriers to participation. Overall, nine SSIs were recorded, eight through the Isla surveillance and one through a hospital transfer readmission. The carbon emission associated with the SSI ranged from 5 to 2615 kg CO2e. Conclusion: In a real-world setting, using patient smartphones is an effective method to collect PDS, including wound images.

Citation

Rochon, M., Jawarchan, A., Fagan, F., Otter, J., & Tanner, J. (2023). Image-based digital post-discharge surveillance in England: measuring patient enrolment, engagement, clinician response times, surgical site infection, and carbon footprint. Journal of Hospital Infection, 133, 15-22. https://doi.org/10.1016/j.jhin.2023.01.001

• Journal Article Type: Article
• Acceptance Date: Jan 5, 2023
• Online Publication Date: Jan 13, 2023
• Publication Date: Mar 1, 2023
• Deposit Date: Feb 2, 2023
• Publicly Available Date: Feb 3, 2023
• Journal: Journal of Hospital Infection
• Print ISSN: 0195-6701
• Electronic ISSN: 1532-2939
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 133
• Pages: 15-22
• DOI: https://doi.org/10.1016/j.jhin.2023.01.001
• Keywords: Photograph, Smartphone, Surveillance, Surgical site infection, Carbon emissions
• Public URL: https://nottingham-repository.worktribe.com/output/16789946
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0195670123000038