Health Services Research, Regenstrief Institute Inc, Indianapolis, Indiana, USA
Health Services Research, Regenstrief Institute Inc, Indianapolis, Indiana, USA.
BMJ Open Qual. 2023 Aug;12(3). doi: 10.1136/bmjoq-2023-002385.
Clinical texting systems (CTS) are widely used in hospitals for team communication about patients. With more institutions adopting such systems, there is a need to understand how texting is being used in clinical practice.
We conducted content analysis of 809 randomly selected message threads sent to and from hospitalists in a 9-month window. The process, purpose and content of messages were analysed. We also examined messages for personal content (to identify whether CTS was being used for professional matters) and discussion of near miss errors. The risk levels of these near misses were also assessed.
Most messages focused on clinical management of patient needs (62%; n=498) and functioned to provide a notification or update regarding clinical care (64%; n=518) or make a request of the recipient (63%; n=510). Personal content was infrequent in message threads (10%; n=80). Five per cent (n=38) of message threads included discussion of a near miss, and most near misses posed low clinical risk overall (66%; n=25).
Most CTS communication centred around direct clinical management. Fewer messages were focused on non-clinical areas such as administrative tasks or personal communication. Further examination of care delivery, error communication and the consequences of the care discussed in messages would help clinical leaders understand the impact of clinical texting on teamwork and quality of care.
临床短信系统（CTS）在医院中被广泛用于团队之间的患者沟通。随着越来越多的机构采用此类系统，有必要了解短信在临床实践中的使用情况。
我们对在 9 个月的时间窗口内向和从医院内科医生发送的 809 条随机选择的消息线程进行了内容分析。分析了消息的过程、目的和内容。我们还检查了消息中的个人内容（以确定 CTS 是否用于专业事务）和接近错误的讨论。这些接近错误的风险水平也进行了评估。
大多数消息都集中在患者需求的临床管理上（62%；n=498），其功能是提供关于临床护理的通知或更新（64%；n=518）或对收件人提出请求（63%；n=510）。消息线程中的个人内容很少（10%；n=80）。5%（n=38）的消息线程包括对接近错误的讨论，并且大多数接近错误的整体临床风险较低（66%；n=25）。
大多数 CTS 通信都集中在直接的临床管理上。较少的消息集中在非临床领域，如行政任务或个人通信。进一步检查护理提供、错误沟通以及消息中讨论的护理的后果，将有助于临床领导者了解临床短信对团队合作和护理质量的影响。
