Design and Integration of a Texting Tool to Keep Patients' Family Members Updated During Hospitalization: Clinicians'...

Area of Science:

• Health Informatics
• Patient-Centered Care
• Clinical Communication Technology

Background:

• A gap exists in understanding clinician perspectives on patient-centered technologies.
• Digital texting innovations aim to enhance family-centered care during hospitalizations.
• Clinician workflows and experiences with these technologies require investigation.

Purpose of the Study:

• To identify clinician user perspectives on facilitators and barriers of digital texting for family-centered care.
• To analyze clinician feedback on a specific digital texting innovation.
• To explore the impact of texting on clinician workflows and patient family communication.

Main Methods:

• Qualitative study at a tertiary care center in Houston.
• Conducted 3 focus groups with 18 physicians, 5 advanced practice providers, and 10 nurse directors/managers.
• Analyzed 156 real-time alerts of family dissatisfaction using thematic analysis.

Main Results:

• Facilitators included integration with electronic medical records, reduction in outgoing calls, and decreased incoming family calls.
• Barriers identified were disruptive best practice alerts, alerts creating hopelessness, and challenges in scaling up the technology.
• Family dissatisfaction alerts most commonly cited insufficient physician communication (33%) and inconsistent information (31%).

Conclusions:

• Clinicians value inpatient texting for efficient multi-family updates and reducing communication burdens.
• Intentional and meaningful use of texting can decrease family phone calls and improve communication.
• Addressing alert fatigue and ensuring seamless EMR integration are crucial for successful implementation.