title: Using mobile devices for inpatient rounding and handoffs: an innovative application developed and rapidly adopted by clinicians in a pediatric hospital.
abstract: OBJECTIVE
  To describe the usage of a novel application (The FLOW) that allows mobile devices to be used for rounding and handoffs.
  
  
  METHODS
  The FLOW provides a view of patient data and the capacity to enter short notes via personal mobile devices. It was deployed using a "bring-your-own-device" model in 4 pilot units. Social network analysis (SNA) was applied to audit trails in order to visualize usage patterns. A questionnaire was used to describe user experience.
  
  
  RESULTS
  Overall, 253 health professionals used The FLOW with their personal mobile devices from October 2013 to March 2015. In pediatric and neonatal intensive care units (ICUs), a median of 26-26.5 notes were entered per user per day. Visual network representation of app entries showed that usage patterns were different between the ICUs. In 127 questionnaires (50%), respondents reported using The FLOW most often to enter notes and for handoffs. The FLOW was perceived as having improved patient care by 57% of respondents, compared to usual care. Most respondents (86%) wished to continue using The FLOW.
  
  
  CONCLUSIONS
  This study shows how a handoff and rounding tool was quickly adopted in pediatric and neonatal ICUs in a hospital setting where patient charts were still paper-based. Originally developed as a tool to support informal documentation using smartphones, it was adapted to local practices and expanded to print sign-out documents and import notes within the medicolegal record with desktop computers. Interestingly, even if not supported by the nursing administrative authorities, the level of use for data entry among nurses and doctors was similar in all units, indicating close collaboration in documentation practices in these ICUs.
authors.affiliation: Clinical and Health Informatics Research Group, Faculty of Medicine, McGill University, Montreal, Canada.|Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
authors.forename: Aude
authors.initials: A
authors.lastname: Motulsky
authors.affiliation: Clinical and Health Informatics Research Group, Faculty of Medicine, McGill University, Montreal, Canada.|Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
authors.forename: Jenna
authors.initials: J
authors.lastname: Wong
authors.affiliation: McGill University Health Centre, Montreal, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Cordeau
authors.affiliation: McGill University Health Centre, Montreal, Canada.
authors.forename: Jorge
authors.initials: J
authors.lastname: Pomalaza
authors.affiliation: McGill University Health Centre, Montreal, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Barkun
authors.affiliation: Clinical and Health Informatics Research Group, Faculty of Medicine, McGill University, Montreal, Canada.|Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
authors.forename: Robyn
authors.initials: R
authors.lastname: Tamblyn
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D006776:Hospitals, Pediatric; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D063731:Mobile Applications / Q000706:statistics & numerical data; D062209:Patient Handoff; D010564:Personnel, Hospital; D011792:Quebec; D000068997:Smartphone; D011795:Surveys and Questionnaires; D014584:User-Computer Interface
keywords: electronic documentation; handoff and rounding tool; intensive care units; smartphones