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The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi

More than two-thirds of newborn lives could be saved worldwide if evidence-based interventions were successfully implemented. We developed the NeoTree application to improve quality of newborn care in resource-poor countries. The NeoTree is a fully integrated digital health intervention that combine...

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Autores principales: Crehan, Caroline, Kesler, Erin, Nambiar, Bejoy, Dube, Queen, Lufesi, Norman, Giaccone, Matteo, Normand, Charles, Azad, Kishwar, Heys, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340059/
https://www.ncbi.nlm.nih.gov/pubmed/30713745
http://dx.doi.org/10.1136/bmjgh-2018-000860
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author Crehan, Caroline
Kesler, Erin
Nambiar, Bejoy
Dube, Queen
Lufesi, Norman
Giaccone, Matteo
Normand, Charles
Azad, Kishwar
Heys, Michelle
author_facet Crehan, Caroline
Kesler, Erin
Nambiar, Bejoy
Dube, Queen
Lufesi, Norman
Giaccone, Matteo
Normand, Charles
Azad, Kishwar
Heys, Michelle
author_sort Crehan, Caroline
collection PubMed
description More than two-thirds of newborn lives could be saved worldwide if evidence-based interventions were successfully implemented. We developed the NeoTree application to improve quality of newborn care in resource-poor countries. The NeoTree is a fully integrated digital health intervention that combines immediate data capture, entered by healthcare workers (HCW) on admission, while simultaneously providing them with evidence-based clinical decision support and newborn care education. We conducted a mixed-methods intervention development study, codeveloping and testing the NeoTree prototype with HCWs in a district hospital in Malawi. Focus groups explored the acceptability and feasibility of digital health solutions before and after implementation of the NeoTree in the clinical setting. One-to-one theoretical usability workshops and a 1-month clinical usability study informed iterative changes, gathered process and clinical data, System Usability Scale (SUS) and perceived improvements in quality of care. HCWs perceived the NeoTree to be acceptable and feasible. Mean SUS before and after the clinical usability study were high at 80.4 and 86.1, respectively (above average is >68). HCWs reported high-perceived improvements in quality of newborn care after using the NeoTree on the ward. They described improved confidence in clinical decision-making, clinical skills, critical thinking and standardisation of care. Identified factors for successful implementation included a technical support worker. Coproduction, mixed-methods approaches and user-focused iterative development were key to the development of the NeoTree prototype, which was shown to be an agile, acceptable, feasible and highly usable tool with the potential to improve the quality of newborn care in resource-poor settings.
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spelling pubmed-63400592019-02-02 The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi Crehan, Caroline Kesler, Erin Nambiar, Bejoy Dube, Queen Lufesi, Norman Giaccone, Matteo Normand, Charles Azad, Kishwar Heys, Michelle BMJ Glob Health Practice More than two-thirds of newborn lives could be saved worldwide if evidence-based interventions were successfully implemented. We developed the NeoTree application to improve quality of newborn care in resource-poor countries. The NeoTree is a fully integrated digital health intervention that combines immediate data capture, entered by healthcare workers (HCW) on admission, while simultaneously providing them with evidence-based clinical decision support and newborn care education. We conducted a mixed-methods intervention development study, codeveloping and testing the NeoTree prototype with HCWs in a district hospital in Malawi. Focus groups explored the acceptability and feasibility of digital health solutions before and after implementation of the NeoTree in the clinical setting. One-to-one theoretical usability workshops and a 1-month clinical usability study informed iterative changes, gathered process and clinical data, System Usability Scale (SUS) and perceived improvements in quality of care. HCWs perceived the NeoTree to be acceptable and feasible. Mean SUS before and after the clinical usability study were high at 80.4 and 86.1, respectively (above average is >68). HCWs reported high-perceived improvements in quality of newborn care after using the NeoTree on the ward. They described improved confidence in clinical decision-making, clinical skills, critical thinking and standardisation of care. Identified factors for successful implementation included a technical support worker. Coproduction, mixed-methods approaches and user-focused iterative development were key to the development of the NeoTree prototype, which was shown to be an agile, acceptable, feasible and highly usable tool with the potential to improve the quality of newborn care in resource-poor settings. BMJ Publishing Group 2019-01-16 /pmc/articles/PMC6340059/ /pubmed/30713745 http://dx.doi.org/10.1136/bmjgh-2018-000860 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Practice
Crehan, Caroline
Kesler, Erin
Nambiar, Bejoy
Dube, Queen
Lufesi, Norman
Giaccone, Matteo
Normand, Charles
Azad, Kishwar
Heys, Michelle
The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi
title The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi
title_full The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi
title_fullStr The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi
title_full_unstemmed The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi
title_short The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi
title_sort neotree application: developing an integrated mhealth solution to improve quality of newborn care and survival in a district hospital in malawi
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340059/
https://www.ncbi.nlm.nih.gov/pubmed/30713745
http://dx.doi.org/10.1136/bmjgh-2018-000860
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