title: A smartphone-enabled communication system to improve hospital communication: usage and perceptions of medical trainees and nurses on general internal medicine wards.
abstract: BACKGROUND
  There is increasing interest in the use of information and communication technologies to improve how clinicians communicate in hospital settings.
  
  
  METHODS
  We implemented a communication system with support for physician handover and secure messaging on 2 general internal medicine wards. We measured usage and surveyed physicians and nurses on perceptions of the system's effects on communication.
  
  
  RESULTS
  Between May 2011 and August 2012, a clinical teaching team received, on average, 14.8 messages per day through the system. Messages were typically sent as urgent (69.1%) and requested a text reply (76.5%). For messages requesting a text reply, 8.6% did not receive a reply. For those messages that did receive a reply, the median response time was 2.3 minutes, and 84.5% of messages received a reply within 15 minutes. Of those who completed the survey, 95.3% were medical residents (82 of 86) and 81.7% were nurses (83 of 116). Medical trainees (82.8%) and nursing staff (78.3%) agreed or strongly agreed that the system helped to speed up their daily work tasks. Overall, 67.1% of the trainees and 73.2% of nurses agreed or strongly agreed that the system made them more accountable in their clinical roles. Only 35.8% of physicians and 26.3% of nurses agreed or strongly agreed that the system was useful for communicating complex issues.
  
  
  CONCLUSIONS
  In summary, with a system designed to improve communication, we found that there was high uptake and that users perceived that the system improved efficiency and accountability but was not appropriate for communicating complex issues.
authors.affiliation: Centre for Innovation in Complex Care, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Division of General Internal Medicine, University Health Network, Toronto, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Wu
authors.forename: Vivian
authors.initials: V
authors.lastname: Lo
authors.forename: Dante
authors.initials: D
authors.lastname: Morra
authors.forename: Eva
authors.initials: E
authors.lastname: Appel
authors.forename: Teri
authors.initials: T
authors.lastname: Arany
authors.forename: Beth
authors.initials: B
authors.lastname: Curiale
authors.forename: Joanne
authors.initials: J
authors.lastname: Ryan
authors.forename: Sherman
authors.initials: S
authors.lastname: Quan
mesh_terms: D040421:Cell Phone / Q000592:standards / Q000706:statistics & numerical data*; D003142:Communication; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000379:methods* / Q000592:standards; D007396:Internship and Residency / Q000379:methods / Q000592:standards; D008297:Male; D009726:Nurses / Q000592:standards; D010348:Patient Care Team / Q000592:standards; D010820:Physicians / Q000592:standards; D060145:Text Messaging / Q000592:standards / Q000706:statistics & numerical data*