Secure Chat: Evidence-Based Practice COVID-19 Pandemic Rapid Response Telecommunications Integration

Purpose: To provide healthcare personnel electronic platforms to communicate instant messaging to colleagues while caring for patients in isolation while also meeting Joint Commission means.

Background: The acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that emerged in December 2019 was officially named by the World Health Organization (WHO) as COVID-19 (Shi et al., 2020). Since December 2019, the highly contagious virus has led to an international outbreak that required the United States to mobilize all efforts for healthcare systems to provide care to the COVID-19 population without compromising safety and personal protective equipment (PPE) of the front-line healthcare staff. PPE shortages pushed operational leaders during this pandemic to find interventions that would provide frontline staff the ability to provide and communicate patient needs when in isolation rooms without breaking or wasting PPE gear (The, 2020).

Evidence-based practice methodology: A large academic health system in Southern California utilized their selected electronic medical record (EMR) platform and integrated a secure instant messaging platform that was launched for use in both the ambulatory care and inpatient settings. An outreach approach with informatics and operational leaders was initiated by the informatics department to ensure engagement and clarity of the system (Tesga et al., 2019). Nurse informaticists created guidelines that was vetted and approved by administration and frontline staff. The informatics department was critical to ensuring end users were not only aware of appropriate use but engagement sustained as well.

Outcome: Initial launch pre-pandemic on a selected pilot department reached to over 66,000 messages weekly within one month. Survey results pre- and post-survey of the pilot department indicate healthcare staff see secure chat as beneficial and improving communication between different healthcare disciplines. Due to the positive results, a rapid integration of secure chat to the whole healthcare system in response to the COVID-19 pandemic has led to weekly message counts to over 90,000.

Conclusion: At a macrosystem level, this program was adopted easily due to a combination of clear guidelines on appropriate use for non-urgent needs and integration within a widely used EMR system. This suggests that EHR-integrated messaging systems can be easily adopted for clinical communication. It can be noted that such a tool requires informaticists to generate compliance, appropriate clinical case use, and interdisciplinary collaboration to ensure the messaging system's success. Additionally, these easily accessible messaging platforms have given the ability for healthcare workers and patients to communicate while still continuing to provide safe patient care, minimizing infection transmission, and reducing PPE wastage while in an isolation setting.

References
1) Shi, Y., Wang, G., Cai, X. P., Deng, J. W., Zheng, L., Zhu, H. H., . . . Chen, Z. (2020). An overview of COVID-19. J Zhejiang Univ Sci B, 21(5), 343-360. doi:10.1631/jzus.B2000083
2) The, L. (2020). COVID-19: protecting health-care workers. Lancet, 395(10228), 922. doi:10.1016/s0140-6736(20)30644-9
3) Tsega, S., Kalra, A., Sevilla, C. T., & Cho, H. J. (2019). A bottom-up approach to encouraging sustained user adoption of a secure text messaging application. Applied clinical informatics, 10(2), 326–330. https://doi.org/10.1055/s-0039-1688554

Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.