Summary
Background
In hospitals, effective and efficient communication among care providers is critical
to the provision of high-quality patient care. Yet, major problems impede communications
including the frequent use of interruptive and one-way communication paradigms. This
is especially frustrating for frontline providers given the dynamic nature of hospital
care teams in an environment that is in constant flux.
Methods
We conducted a pre-post evaluation of a commercially available secured messaging mobile
application on 4 hospital units at a single institution for over one year. We included
care providers on these units: residents, hospitalists, fellows, nurses, social workers,
and pharmacists. Utilization metrics and survey responses on clinician perceptions
were collected and analyzed using descriptive statistics, the Kruskal-Wallis test,
and Mann-Whitney U test where appropriate.
Results
Between May 2013 and June 2014, 1,021 providers sent a total of 708,456 messages.
About 85.5% of total threads were between two providers and the remaining were group
messages. Residents and social workers/clinical resource coordinators were the largest
per person users of this communication system, sending 9 (IQR 2–20) and 9 (IQR 2–22)
messages per person per day, and receiving 18 (IQR 5–36) and 14 (IQR 5–29) messages
per person per day, respectively (p=0.0001). More than half of the messages received
by hospitalists, residents, and nurses were read within a minute. Communicating using
secured messaging was found to be statistically significantly less disruptive to workflow
by both nursing and physician survey respondents (p<0.001 for each comparison).
Conclusions
Routine adoption of secured messaging improved perceived efficiency among providers
on 4 hospital units. Our study suggests that a mobile application can improve communication
and workflow efficiency among providers in a hospital. New technology has the potential
to improve communication among care providers in hospitals.
Citation: Patel N, Siegler JE, Stromberg N, Ravitz N, Hanson CW. Perfect storm of inpatient
communication needs and an innovative solution utilizing smartphones and secured messaging.
Keywords
Communication - provider-provider interaction - mobile - secure texting - secure-messaging