Table 4.
Description of activities during the adoption phase
| Activity | Objective | Target (ED, staff, patients, patient advisors) | Measurement tool and method | Outcome of interest |
|---|---|---|---|---|
| 1. Installing SurgeCon’s digital whiteboard application | To advise when to use volume-based staffing (shifting staff between areas of the hospital based on workload), appropriate and timely involvement of hospital management, and overcapacity protocols, which may otherwise be overlooked by distracted frontline ED staff | ED | Protocol-driven software platform | Online illustration of ED organization and wait time |
| 2. Data collection | To enhance the platform and update ED staff | ED | SurgeCon platform and ED secondary data | Enhancing ED functioning |
| 3. Training frontline SurgeCon champions | To provide ongoing learning related to using the new system and the successful uptake and adoption of SurgeCon | ED staff | Participant observation | Solving practical or technical issues with using SurgeCon |
| 4. Staff training | To encourage ED staff to become active participants in the improvement process | ED staff | Interactive simulation coursea, SurgeCon eHealth platform trainingb, and patient centeredness trainingc | Facilitating the implementation of quality improvement |
| 5. Site assessment | To determine whether the site is capable of implementing the platform as intended given the level of resources and staff commitment | ED staff | Champion observation and site coordinator reports | Assisting ED staff in development of SurgeCon |
| 6. Establishing a patient-centric ED environment | To improve the overall appearance of physical spaces in the ED | ED | Patient advisors’ observation and site assessment checklist | To improve patient satisfaction |
| 7. Conducting patient-reported experiences, patient satisfaction telephone interviews, and semi-structured patient interview | To consult with patients, get feedback from them, study their lived-experiences | ED patients | Patient-reported experiences and patient Satisfaction survey and semi-structured patient interview guide | Develop strategies to overcome the challenges of patient satisfaction |
aInteractive Simulation Course. This module focuses on an ED improvement flow sustainability strategy. The aim will be to provide information on the rationale underpinning SurgeCon and how it works in the practice setting using case-based scenarios. It will be interactive allowing for questions and answers and ensuring the learning outcomes are achieved
bThis module will help ED staff: (1) become familiar with the digital whiteboard application, (2) learn how the system collects and reports information, (3) learn how to interpret system generated notices and warnings, (4) assign protocol tasks, and (5) learn effective response strategies to system notices and warnings
cThis module includes an educational session which reinforces the following topics: (1) providing quality ED care to all patients regardless of urgency, (2) treating all patients with respect, and (3) demonstrating that the patient’s visit to an ED must always be considered necessary as they may have no other option