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Characterization of Secure Message Use in a Children's Hospital
Austin DeChalus1,2,3, Brooke Luo1,2,3,4, Amina Khan4
1Section of Pediatric Hospital Medicine, Children's Hospital of Philadelphia, Pennsylvania.
Insights
Front-line physicians and advanced practice providers (APPs) experienced the highest secure messaging burden in a children's hospital. Secure message response times were nearly immediate, but further study is needed on well-being and patient safety.
Area of Science:
- Clinical Informatics
- Healthcare Communication
- Pediatric Hospital Medicine
Background:
- Secure messaging is prevalent among hospital clinicians but understudied in pediatric settings.
- Understanding communication patterns is crucial for optimizing workflows in children's hospitals.
Purpose of the Study:
- To quantify secure message volume, response times, and emoji use in a pediatric hospital.
- To identify differences in secure messaging metrics across clinical roles and units.
Main Methods:
- A 6-month retrospective analysis of secure message data from 3 inpatient units at a tertiary care children's hospital.
- Secure message activity was isolated to clinical shifts and analyzed by unit and clinician role.
- Statistical analyses were performed to compare message volume, read/response times, and emoji reactions.
Main Results:
- 2,848,677 secure messages were exchanged by 2,493 clinicians.
- Physicians and advanced practice providers (APPs) on front-line care had the highest message volume (median 13.4 messages/hour).
- Significant differences in message volume and response times were observed across clinical roles and units (P<0.001).
Conclusions:
- Front-line physicians and APPs face the greatest secure messaging workload.
- Secure messaging systems demonstrated near-instantaneous read and response times.
- Further research is required to assess the impact of secure messaging on clinician well-being and patient safety.
Objectives:
Secure messaging is an increasingly common mode of communication among hospital-based clinicians. The use of these systems in pediatric settings is poorly understood. We sought to describe secure message volume, message response time, and emoji reaction use in a large children's hospital.
Methods:
We extracted 6 months of secure message data from staff working on 3 inpatient units of an urban tertiary care children's hospital. Using assignment data, we isolated secure message activity during clinical shifts on these 3 units to report message volume, message response time, and emoji reaction use by unit and clinical role. We performed statistical analysis to compare message metrics within units and secondary analysis for key role comparisons.
Results:
A total of 2493 clinicians sent and read 2 848 677 secure messages during the study period. Physicians and advanced practice providers (APPs) providing direct front-line care had the highest message use, a median of 13.4 (IQR 9.9, 17.3) combined sent and received messages per hour. We found significant differences in message volume and time to read, respond, and react to messages across clinical roles within units (all P<0.001). Front-line clinicians across units had significant differences in secure message volume and response times. (P<0.001).
Conclusions:
Front-line physicians and APPs experienced the highest message burden per person across all clinical roles. We demonstrated nearly immediate message read and response times. Additional study is needed to understand the effects of secure messaging on clinician well-being and patient safety.
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