Kelly Dunn, a pediatric nurse practitioner in Medicine Patient Services at Boston Children’s Hospital, is primarily focused on helping families with hospital discharge and improving patient throughput.
A child hospitalized on 9 East, a general medical floor at Boston Children’s Hospital, was nearly ready to go home. The discharge order was written, and prescriptions were sent to the pharmacy. The staff nurse and I completed discharge teaching, competing with a very wiggly toddler for her tired mother’s attention.
Before this family went home, I had one more question: Would you like to receive a text message or email to check up on you once you are home?
Within a minute or two, I had entered the mom’s contact information and her preferred mode of communication (a text message to her cell phone) on an iPad. The family left, reassured to have a way of reaching a nurse familiar with their hospitalization should a problem or question arise at home—and pleased to have the option.
After an organ transplant, patients need to adjust to a lot of strict routines. This is hard, especially for teenagers who are trying to navigate adolescence. Some young patients say it’s difficult to remember when they need to take all their medications to prevent organ rejection, especially when they’re not feeling ill. Others complain that their parents’ constant harping to follow their care team’s instructions makes them want to do the exact opposite.
No matter the reason, thousands of teenagers are at risk of compromising their grafted organ.
Researchers at Boston Children’s Pediatric Transplant Center are developing a smartphone application that they hope will help adolescents understand the importance of taking care of themselves. But they realize that it’s not enough to take a clinical approach and it give an app makeover. In other words, to truly make an impact on teenagers, the app needs to be more than an electronic version of their parents.
“We really need to create ways to communicate with young patients that’s right for their age and treatment stage,” says Kristine McKenna, PhD, a psychologist with the Pediatric Transplant Center. “If you’re too patriarchal, or if you try to dumb things down too much, teens pick up on that and resent it. But if it’s too high-level they can become overwhelmed.”
Your child has been in the hospital and it’s discharge day. It’s a chaotic scene: You’re trying to take care of him and maybe his little sister who keeps running down the hall, while completing hospital paperwork and packing your bags.
You’re finally out the door, in your car, kids strapped in and … what? You’ve just lost contact with the medical professionals who took care of your son. What was it they said to do at home again?
Perhaps you try phoning but can’t get through to your doctor. Or you try to email through the hospital’s secure system, but can’t put your hands on the password. The doctors hope you remember to pick up your son’s meds.
Vinny Chiang, a physician at Children’s Hospital Boston, came up with a simple idea. Could day-after communication with patients be “pushed” — proactive and automated? Could it be texted?
It seems positively quaint to care about the amount of time kids spend watching TV. These days, a television is often mere audiovisual wallpaper for a teen or preteen who is texting on his cell phone while listening to music on earphones and, on the computer, checking out an online video (oops, he sees you! quick screen change to homework).
What impact is this full multimedia immersion having on a generation of kids? For all the social and educational benefits of digital devices, studies also have linked texting and the state of being constantly wired to bad educational and health outcomes. But no one’s really quantified this exposure, or the degree of media multitasking – until now.