Georgia CTSA Joins Forces with Children’s Healthcare of Atlanta to Develop Nurse-Patient Communicator App

At Children’s Healthcare of Atlanta, children with limited English proficiency (LEP) currently use a Communications Board and point to the need they are trying to communicate. Georgia Clinical and Translational Science Alliance’s (Georgia CTSA) AppHatchery consulting and development service is helping Children’s Heathcare of Atlanta improve care for LEP patients by creating a mobile app that combines visual icons and words for point-of-care bedside tasks with audio cues. Patients can hear words for the task in their language, see a picture, and read a description.

Children’s Healthcare of Atlanta (Children’s) employees know better than anyone what it means to do Everything Possible to Make Anything Possible for Kids. Whether they are inspiring kids to take their first steps, or making miracles happen to celebrate a child’s major life milestones, or developing innovative creations to overcome obstacles and improve care, our teams are always looking to go the extra mile for our patients.

Several years ago, a critical care nurse at Egleston was inspired to push beyond limits while caring for a patient with Limited English Proficiency (LEP). Her patient needed something, but the language barrier made it challenging for him to communicate with his nurse. At the time, an interpreter was busy with another patient. Instead of delaying care, the nurse sketched pictures to ask the patient what he required.

Encouraged by the interaction, the nurse shared her idea with a team from the Department of Nursing and Allied Health Research and Evidenced-Based Practice, who developed her concept into the Nurse Communication Board—an interactive communication tool to help nurses respond more quickly to the needs of LEP patients. The tool combines visual icons— designed to be culturally appropriate, gender neutral and approachable to all ages—with words representing common point-of-care tasks. Nurses use the Communication Board, which is available in five languages, by asking patients to point to the need they are trying to communicate.

Doing Everything Possible

As Director of Nursing Research and Evidence, Christina Calamaro, PhD, has played a leading role in the team’s efforts to develop the Board. Dr. Calamaro is passionate about helping our Children’s nurses bring their ideas to life. “I’ve always believed nurses are the best innovators. We’re at the bedside day after day. We take the time to listen to our patients and understand what their needs are,” Dr. Calamaro said. “I always ask myself how I can make care better.”

Last summer, Dr. Calamaro and her team joined forces with several clinicians from Children’s and the Emory University Nell Hodgson Woodruff School of Nursing, as well as the AppHatchery—a mobile app consulting and development service offered by the Georgia Clinical & Translational Science Alliance—to submit a proposal for the Johnson & Johnson Nursing Quickfire Innovate Challenge. Their goal: to grow the Nurse Communication Board ‘s impact by turning it into a mobile application.

This past October, Johnson & Johnson announced their project had been selected from hundreds of applicants as one of two winners for the Challenge, granting the team $100K and access to mentoring from experts across the Johnson & Johnson Family of Companies to help develop the app.

Adding to the original concept, the Nurse-Patient app combines visual icons and words for point-of-care bedside tasks with audio cues. This addition allows patients to hear the word for the task in their own language as well as see the picture and written description—which is especially helpful for patients with low literacy. The app also includes a button for patients to request an interpreter for a longer conversation if desired. The team is currently piloting the app for Spanish-speaking families, with the goal of expanding to other languages once the app is live.

“Being able to communicate with patients for these short, point-of-care tasks is so important. The actions can be as simple as identifying something to comfort an upset child. But it’s helpful because these situations can become more urgent if care is delayed while waiting for an interpreter. This also frees the interpreter for longer conversations, such as interpreting consent before a procedure or explaining discharge instructions,” Dr. Calamaro said.

Making Anything Possible for Kids

After months of hard work and fine-tuning with design engineers from the AppHatchery, Dr. Calamaro’s team hopes to begin testing the Nurse-Patient Communicator app with select nursing teams this summer. The team is thrilled at the promise the tool shows for improving care and patient experience for kids with LEP and low literacy.

“I love the new Children’s Vision to do Everything Possible to Make Anything Possible for Kids. This tool is a great example of how we are living up to that goal,” Dr. Calamaro said. “We are breaking down barriers limiting the really good care our nurses want to provide. If we can help make just one patient more comfortable or help one nurse provide care more efficiently, then it will all be worth it.”

Dr. Calamaro encourages all Children’s employees to speak up and share their ideas for making anything possible for kids. “I hope this opens the door for employees, especially nurses, to come forward with their innovative ideas,” Dr. Calamaro said. “After all, you never know when you might have an idea that could change a child’s life, or the world.”

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  • Clinical and Translational Science
  • Clinical and Translational Research
  • Children’s Health
  • Pediatrics
  • Health Equity

Emory University

CTSA Program In Action Goals
Goal 2: Engage Patients and Communities in Every Phase of the Translational Process
Goal 3: Promote the Integration of Special and Underserved Populations in Translational Research Across the Human Lifespan
Goal 4: Innovate Processes to Increase the Quality and Efficiency of Translational Research, Particularly of Multisite Trials