Applications (APPS), an innovative health trend: development of a mobile application for the management of critical events during orthopaedic and trauma surgery

Abstract

Background: The manner in which a critical intra-operative event is addressed can make the difference between life and death. Robust evidence shows that surgical teams do not adequately handle complications during surgery. The literature reports a rate of 145 critical events per 10,000 procedures, with medical errors being the leading cause of preventable injury and death in patients during surgery. Through a national initiative and an interdisciplinary team, we developed a software program in the form of an application (APP), for tablets and smartphones that allows to systematically deal with critical events in orthopaedic surgery. The tool was tested in high-fidelity simulation scenarios of operating theatres, with real clinical cases. To date, no similar tool has been reported in the literature.
Materials and methods: An application was developed for mobile phones and tablets in format for Android and IOS using POP (prototyping on paper) and Microsoft. This application contains a flowchart that allows the early identification of a critical event during surgery, and once detected provides the steps for appropriate coping based on the best available evidence. In a high-fidelity simulation theatre environment, the usefulness of the application and the diagrams, as well as the perception of the members of the medical team on its use were tested.
Results: The application use improved response times and adherence to critical care processes. Surgical teams reported comfort with the use of the application.
Discussion: Applications as cognitive aids have proven useful in different areas of knowledge. Given the small sample size, it is difficult to infer the significance of the results. On the other hand, the literature is conclusive as far as the usefulness of the cognitive aids for the resolution of medical problems. Initiatives, such as that proposed have the potential to improve patient safety, and are a national example of innovation for the world, and goes hand in hand with the thinking of Orthopaedics and Traumatology in Colombia.
Level of evidence: II.