Assessing the implementation of TickiT® during group clinic sessions with patients who have neonatal brachial plexus injury (NBPI): a quality improvement study


The implementation process of e-health tools in clinical settings is often not focused on. The lack of attention to factors such as timing of implementation, identifying personal responsible for administering the tool, and ensuring that staff are comfortable with the device, may lead to suboptimal adoption of e-health technology.

To collect patient-reported data before the NBPI group clinic at SickKids, clinicians from the Rehabilitation Department sought out the iPad-based survey platform, TickiT®, to create a specific pre-assessment tool to address patients’ concerns, such as changes in pain and mobility and difficulty when performing activities of daily living. A pre-clinic survey for the NBPI clinic is critical, as patients present with a large variation of symptoms: an efficient way to collate and review patient data is needed to ensure that diverse patient concerns are addressed.

This quality improvement (QI) study assessed the implementation of TickiT® (the pre-clinic survey) using an observational approach to learn of facilitators and barriers associated with e-health adoption and to identify areas of improvement. Observations were performed during three NBPI clinics. Results showed that TickiT® was adopted gradually overtime and that someone acting as an early facilitator was instrumental in encouraging clinician engagement with the tool. Barriers and facilitators to e-health implementation should be considered before initiating the adoption of a novel tool.

Capstone Team: 

Elizabeth Cruchley


Capstone Advisory Committee:

Emily Ho
Miriam Kaufman
Jennifer Stinson


TRP Faculty Lead:

Dr. Lucy Osborne