Related Experiment Video
Updated: Jul 4, 2026
11:27
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Overnight consult message volume and patterns to pediatric subspecialty fellows
Lauren Coogle1, Brooke Luo2,3,4,5, Amina Khan5
1Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.
Journal of Hospital Medicine
|July 3, 2026
Summary
Pediatric subspecialists use secure text message systems (STMS) overnight, impacting trainee sleep. On-call fellows received significantly more messages when in the hospital versus at home, highlighting communication workload concerns.
Area of Science:
- Pediatric hospital medicine
- Medical education
- Clinical informatics
Background:
- Pediatric subspecialists offer critical 24/7 guidance in children's hospitals.
- Secure Text Message Systems (STMS) are common for consultations, potentially affecting trainee well-being and sleep.
- Existing guidelines on trainee duty hours predate modern communication technologies.
Purpose of the Study:
- To quantify STMS metadata for on-call pediatric subspecialty fellows overnight.
- To analyze message volume and timing patterns over a 6-month period.
- To assess the impact of overnight messaging on clinical workload.
Main Methods:
- Analysis of STMS metadata over six months (March-August 2024) at a single children's hospital.
- Comparison of message counts and timing between fellows in-hospital and at-home.
- Statistical analysis of message volume and inter-message intervals across subspecialties.
Main Results:
- Significant differences in overnight call shift message volume were observed across subspecialties (p < .001).
- In-hospital fellows received substantially more messages per shift (53) than at-home fellows (21; p < .001).
- Median longest time between messages varied significantly, from 1.6 to 10.0 hours across subspecialties (p < .001).
Conclusions:
- Overnight STMS use creates a significant messaging burden for pediatric subspecialty fellows.
- Current clinical workload and duty hour guidelines may not adequately address the impact of continuous communication.
- Further evaluation is needed to understand the effects of overnight messaging on trainee sleep and well-being.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
01:30Pulse rhythm
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:26Types of Reports III: Telephone and Verbal Reports
Telephone and Verbal Reports in healthcare settings are two communication methods for conveying therapeutic instructions from healthcare providers to nurses or other healthcare staff.
Here's an overview of each type:
Telephone Orders
Here's an overview of each type:
Telephone Orders