A research study from York University, one of my almae matres, studied text messages sent between nurses and physicians in deteriorating internal medicine patients requiring escalation to intensive care unit (ICU) to identify issues in failures to rescue. Looking at records from 2012 to 2014 at the Toronto General Hospital, the team found that message quality was positively linked to survival. The study highlights the need for a standardized and responsive text-based communication system.
As a taxonomist and cataloguer, I’m pleased to see a degree of authority control (or standardized vocabulary) used in these text messages, as shown in this legend of abbreviations:
RR = respiratory rate; NP = nasal prongs; bpm = beats per minute; BP = blood pressure; pt = patient; NS = normal saline; TM = tracheostomy mask; A&O = alert and oriented; ABG = arterial blood gas; CCRT = critical care response team (rapid response team).
I’m interested also in whether hospitals have a plan for managing these records. I consider these records to have business value, since they document decisions made, and transmit patient information. Are these text messages subjected to any records and information management policies and standards? Are they subject to retention schedules? Given the potential confidential nature of the content of these messages, how is their security maintained? Are personnel using mobile devices that are owned by the hospital and protected by firewalls? There is certainly a lot of ground to explore here. I think a discussion with the authors might be interesting.