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Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

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More Than a Message: Death by a 1000 "Chats".

Darcy Wooten¹, Christian Hendrix¹, Joshua Nordman¹

¹Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine, St. Louis, Missouri, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America

|February 14, 2026

Summary

This summary is machine-generated.

Secure electronic messaging in electronic health records (EHR) aids rapid communication but disrupts Infectious Diseases (ID) consultants. Clearer boundaries and purposeful communication strategies are vital for patient care and clinician well-being.

Keywords:

burnout communication electronic health record high-value care

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Area of Science:

Health Informatics
Clinical Communication
Medical Practice Management

Background:

Secure electronic messaging systems, like Epic Chat within Electronic Health Records (EHRs), have revolutionized hospital communication by enabling fast, asynchronous interactions.
However, the high volume of messages presents significant challenges for Infectious Diseases (ID) consultants, leading to attention fragmentation and disrupted clinical reasoning.
The prevalence of trivial, repetitive, or casually worded messages increases the risk of miscommunication and potential medicolegal issues.

Purpose of the Study:

To analyze the impact of pervasive electronic messaging on Infectious Diseases (ID) consultants' workflow and patient care.
To advocate for improved communication practices and establish clearer boundaries for electronic messaging in clinical settings.
To identify strategies for optimizing electronic communication to enhance patient safety and clinician well-being.

Main Methods:

Qualitative analysis of communication patterns and challenges faced by ID consultants using EHR messaging.
Review of clinical scenarios impacted by electronic message overload.
Development of practical strategies based on expert consensus and best practices.

Main Results:

Constant electronic messaging fragments clinician attention, disrupts clinical reasoning, and poses risks to patient safety.
Ineffective messaging contributes to miscommunication and potential medicolegal risks.
Current practices necessitate a cultural shift towards more purposeful and intentional communication.

Conclusions:

Establishing clear boundaries for electronic messaging versus direct communication is crucial.
Implementing strategies such as response batching, protecting focus time, and promoting messaging etiquette can mitigate negative impacts.
Intentionality in communication methods is essential for optimizing patient care and safeguarding clinician well-being.