Description of Secure Chat Message Volume for Academic Pediatric Hospitalists

Area of Science:

• Healthcare communication technology
• Clinical informatics
• Pediatric hospital medicine

Background:

• Secure text messaging systems (STMS) are integral to modern healthcare communication, enabling rapid information exchange among clinicians.
• While STMS offer benefits, the unpredictable and often high volume of messages can pose challenges.
• Understanding message volume is crucial for optimizing clinical workflows and preventing potential negative impacts on healthcare professionals.

Purpose of the Study:

• To quantify the daily message volume accessed by pediatric hospitalists during clinical shifts.
• To analyze the factors influencing message volume, including shift type (day/night) and triage responsibilities.
• To assess the relationship between patient census and the number of messages handled by hospitalists.

Main Methods:

• A quantitative study was conducted, counting messages sent and received by pediatric hospitalists over a defined period.
• Data were collected for day and night shifts, with specific attention to a hospitalist performing triage duties.
• Negative binomial regression analysis was employed to determine the association between message volume, shift, and daily patient census.

Main Results:

• Pediatric hospitalists accessed a median of 50 messages/day without triage, significantly less than those with triage (109 messages/day).
• Night shift hospitalists accessed a median of 77 messages/day.
• A higher morning patient census correlated positively with increased daytime message volume; hospitalists received 34% more messages than they sent.

Conclusions:

• Pediatric hospitalists manage a substantial volume of secure text messages, even when not the primary contact.
• Triage responsibilities and patient census are significant contributors to high message loads, potentially causing alert fatigue and burnout.
• Optimizing STMS message volume is essential to reduce distractions and improve patient care efficiency.