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Mobile application-based guidelines to enhance patient care and provider education in trauma and acute care surgery
  1. Nicholas A Hakes1,
  2. William C Kethman2,
  3. David Spain1,
  4. Aussama K Nassar1
  1. 1Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
  2. 2Department of Surgery, University Hospitals Research in Surgical Outcomes and Effectiveness Center (RISES), Cleveland, Ohio, USA
  1. Correspondence to Mr Nicholas A Hakes, Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, CA 94305, USA; hakesn{at}


Introduction Providing up-to-date, universally accessible care guidelines and education within a quaternary care center is challenging. At our institution, trauma and acute care surgery guidelines have historically been published using a paper-based format. Mobile application-based guidelines were developed to address the shortcomings of paper-based guidelines.

Methods We assessed the utility, usability, and satisfaction of healthcare providers towards paper-based versus mobile application-based guidelines. A survey was administered to providers within the emergency department and intensive care unit.

Results Fifty of 137 providers responded (36.5% response rate). Nearly half (47.4%, 9 of 19) of those who received a copy of the paper-based guidelines lost the guidelines at least once. Regarding usage of the mobile application-based guidelines, 92.6% (25 of 27) were aware of the application; 92.6% (25 of 27) considered the application comprehensive, 85.2% (23 of 27) thought the application was organized, and 66.7% (18 of 27) thought the application was easy to use. Additionally, 88.9% (24 of 27) found the application moderately, very, or extremely helpful and 85.2% (23 of 27) judged the application moderately, very, or extremely necessary. Overall, 88.9% (24 of 27) were satisfied with the application and indicated likeliness to recommend to a colleague. Seventeen of 27 (63.0%) agreed or strongly agreed that the application improved their provision of trauma and acute care.

Conclusion This survey demonstrates positive usability, utility, and satisfaction among trauma healthcare providers with the mobile application-based guidelines. Additionally, this quality improvement initiative highlights the importance of having comprehensive, organized, and easy-to-use trauma and acute care surgery guidelines and targeted educational materials available on demand. The successful transition from paper to mobile application-based guidelines serves as a model for other institutions to modernize and improve patient care and provider education.

Level of evidence IV.

  • guideline
  • smartphone
  • critical care
  • education, medical

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  • Presented at This project was scheduled to be presented as an oral podium presentation at the Trauma Association of Canada; Halifax, Nova Scotia, Canada; March 2020 (canceled).

  • Contributors NAH: application development, literature review, survey design and administration, data analysis, article writing and revision. WCK: application and software development, article writing and revision. DS: application development, article writing and revision, project supervision. AKN: team lead, application development, survey design and administration, article writing and revision, project supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The Stanford University Institutional Review Board exempted the survey as a quality improvement initiative (ID: 52535). Informed consent was not required since the anonymous survey did not collect any identifiable information and posed no risk to participants.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article. Please direct inquiries to the corresponding author.

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