Characterizing Push Notification Volume and Delivery Patterns in Hospital Medicine

Area of Science:

• Clinical Informatics
• Healthcare Operations
• Patient Safety

Background:

• Push notifications are prevalent in inpatient clinical communication but their volume and patterns are understudied.
• High alert volumes in healthcare are linked to alert fatigue, potentially exacerbated by new notification types.
• Understanding push notification characteristics is crucial for optimizing clinical workflows.

Purpose of the Study:

• To quantify the volume, types, and timing of push notifications for hospitalists.
• To analyze notification patterns across different hospitalist roles within an academic health system.
• To identify potential contributors to alert fatigue in inpatient settings.

Main Methods:

• Cross-sectional analysis of electronic health record (EHR) audit logs from a large academic health system.
• Extracted and categorized all push notifications received by attending hospitalists over a one-year period.
• Summarized notification data by hour, hospitalist role, and device type.

Main Results:

• Ninety-seven hospitalists received over 1.1 million push notifications in one year.
• Notifications averaged 11 per hour, with rounding hospitalists receiving 9 per patient daily.
• Secure messages dominated notifications; results-related alerts were only 2.2%.

Conclusions:

• Hospitalists face a high volume of push notifications, risking alert fatigue and impacting patient safety.
• System-level interventions are needed to prioritize critical alerts and optimize notification settings.
• Enhancing secure messaging infrastructure is vital for clinician focus and patient safety.