Date of Award

Summer 2023

Project Type


College or School




Degree Name

Master of Science

First Advisor

Elizabeth Evans

Second Advisor

Pamela Kallmerten


Background: Communication between emergency medical services (EMS) and the emergency department (ED) is a key part of treating patients being transported by ambulance. This communication is moving away from traditional radio and cell phone calls to the use of secure text-based apps. These apps can generate metrics and provide real time location information that is not available using traditional methods. Increased use of these apps can improve communication between EMS and receiving EDs.

Local Problem: Wildcat hospital introduced the EMS communication app Twiage in May of 2023. There is low utilization of the app and some EMS and ED staff have resisted using it over already existing methods of communication. The specific aim of this quality improvement project is to increase the use of the communication app, Twiage, to above 60% of EMS transports to Wildcat Hospital by July 14th 2023.

Methods: EMS survey followed by an educational intervention that was made available in the Wildcat Hospital ED.

Interventions: In person education was developed based on survey results. Education was provided in a quick, drop-in format at the Wildcat Hospital ED using a demo version of the Twiage app.

Results: There was no improvement of utilization of the Twiage app use, with 47% of EMS communication to the ED via Twiage pre-intervention and 40% post intervention. There was survey data to suggest the key points of the educational intervention addressed some of the barriers to use of the app.

Conclusions: Intervention was not successful at increasing usage of the app. There was survey data to suggest that education helped overcome some of the barriers to use of the app.