Text paging practices need improvement, standardization


Clinical question: What is the content and structure of patient care–related text paging sent in the inpatient setting?

Background: Text paging has become a common form of communication among members of the inpatient multidisciplinary team, but there are potential risks and downsides of text paging, including disruptiveness, inefficiency, and potential patient safety issues.

Study Design: Modified case-study approach.

Setting: The medical inpatient service of an academic tertiary care hospital.

Synopsis: 575 text-page messages relating to 217 unique patients were analyzed in the study. The majority of the messages were sent from nonphysicians to physicians. Common themes that were identified included lack of standardization of textmessage content and format, lack of indicators of the urgency of the message, and lack of clarity within the message. Pertinent information sometimes was missing from the messages, and it was not always clear whether the sender was requesting a response from the recipient.

Bottom line: Text-paging practices may raise patient safety issues that could be addressed by implementation of a standardized, structured approach to this form of communication.

Citation: Luxenberg A et al. Efficiency and interpretability of text paging communication for medical inpatients: A mixed-methods analysis. JAMA Intern Med. 2017;177(8):1218-20.

Dr. Wachter is an assistant professor of medicine at Duke University

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