Improving the Quality of Smartphone-Based Medical Photography for Burns Patients: A Quality Improvement Project

Abstract

Introduction. High-quality clinical photography is essential in burns management, providing an objective record of wound progression, supporting multidisciplinary communication, and fulfilling medico-legal requirements. Smartphone photography is increasingly used for bedside documentation because of its speed and accessibility, but image quality is often inconsistent, and no standardised guidelines currently exist. This quality improvement project aimed to evaluate and improve the quality of smartphone-based burns photography in a busy burns unit.

Methods. A retrospective review of 200 patient image sets was undertaken at Wythenshawe Hospital, Manchester. 100 pre-intervention and 100 post-intervention image sets were assessed against eight parameters adapted from best practice guidelines, including clarity, lighting, background, wound coverage, perpendicular angle, distance, inclusion of close-up and distant views, and documentation of wound location. A concise guidance card containing prompts addressing key photography standards was attached to clinical smartphones to support staff during image capture. Statistical analysis was performed using a chi-square test for independent samples.

Results. Post-intervention, documentation of wound location improved significantly from 17% to 45% (p < 0.001). Modest, non-significant improvements were observed in adequate lighting (57% to 69%) and perpendicular imaging (77% to 85%). Full wound capture increased from 71% to 79%. However, inclusion of both close-up and distant images declined from 39% to 19% (p = 0.002), while other parameters remained largely unchanged.

Discussion and Conclusions. A simple, low-cost intervention produced measurable improvements in the consistency of burns photography, particularly in documentation of wound location. While gains were modest in other domains, the findings suggest that structured visual prompts can improve the consistency of clinical documentation practices. This project highlights the feasibility of low-resource interventions to enhance wound imaging quality. The approach is scalable to other units and healthcare systems, with potential to improve patient safety, communication, and clinical governance. Further studies should assess sustainability and adaptation in wider clinical contexts.