Texting May Speed Up Decision-Making in Nursing Homes
Author: University of Missouri-Columbia | Contact: missouri.edu
Peer-Reviewed Publication: N/A
Library of Related Papers: Disability Chat Rooms Publications
Synopsis: Texting may help reduce avoidable hospitalizations, speed up decision-making, and improve the quality of care in nursing homes. Currently, when bedside nurses send faxes or leave voicemails and wait to hear back from physicians, social workers, specialists, therapists, registered nurses, and family members of the resident, by the time they hear back, there has already been a missed opportunity for early intervention. With text messages, bedside nurses can contact all parties involved instantly, which speeds up decision-making and allows for earlier interventions. Hence, there is the potential for the hospital transfer to be avoided. It's an easy, convenient, low-cost solution to a serious problem.
Text messaging, or texting, is the act of composing and sending electronic messages, typically consisting of alphabetic and numeric characters, between two or more users of mobile devices, desktops/laptops, or another type of compatible computer. Text messages may be sent over a cellular network using the Short Messaging Service (SMS) or may also be sent via an Internet connection. Text messages are used for personal, family, business, and social purposes. Governmental and non-governmental organizations use text messaging for communication between colleagues.
Each year, billions of dollars are spent transferring residents from nursing homes to hospitals. Now, a research team at the University of Missouri is examining how a common form of communication - texting - can be used by nursing home staff to speed up decision-making and prevent the decline of residents' health that can lead to costly and traumatic hospital transfers.
To help address this costly and stressful issue, a three-year, $1 million grant from the National Institutes of Health (NIH) will help MU researchers show how nursing home staff can securely use HIPPA-compliant text messages to speed up decision-making in a way that can allow residents to be safely cared for in the nursing home without the need for a traumatic transfer to the hospital.
"Deciding whether or not to transfer a nursing home resident to the hospital may seem simple, but it is extremely complicated with many factors involved," said Kimberly Powell, an assistant professor at the MU Sinclair School of Nursing and the grant's principal investigator.
"Bedside nurses often use a fax machine or leave voicemails to communicate with physicians or advanced practice nurses who are not in the facility. You also need to consider the preferences of the patient and their family members and if the patient has a cognitive impairment like dementia, which two-thirds of nursing home residents do. They may be unable to communicate their preferences, complicating things further."
Powell said quick decision-making is crucial in these situations, as early interventions and noticing changes in a resident's condition as soon as possible can prevent further health complications or health deteriorations that often lead to avoidable hospital transfers.
"Currently, when bed-side nurses send faxes or leave voicemails and wait to hear back from physicians, social workers, specialists, therapists, registered nurses, and family members of the resident, by the time they hear back, there has already been a missed opportunity for early intervention, and the resident must get transferred to the hospital because it is too late to intervene," Powell said.
"Whereas, with text messages, bedside nurses can contact all parties involved instantly, which speeds up decision-making and allows for earlier interventions, so there is the potential for the hospital transfer to be avoided. It's an easy, convenient, low-cost solution to a serious problem."
For the grant project, Powell will analyze the effectiveness of a HIPAA-secure text messaging platform, Mediprocity, used in an earlier study by nursing home staff in 16 Missouri nursing homes. That study was part of the Missouri Quality Improvement Initiative, a $35 million program funded by the Centers for Medicare and Medicaid that implemented advanced practice registered nurses full-time into nursing homes to reduce avoidable hospitalizations.
By learning what went well in the 16 Missouri nursing homes and what can be improved upon, Powell's efforts can help nursing homes adopt similar technology to improve the quality of care delivered to their residents.
The interdisciplinary team included nurses, physicians, social workers, specialists, therapists, and family members of nursing home residents, all of whom were included in the same text message thread.
"Our secure, HIPPA-compliant technology services are focused specifically on long-term care," said Mason Rothert, co-founder and CEO of Mediprocity, the organization that developed the technology being used in the grant. "By reducing the time it takes for the nursing home facility, physicians, and pharmacies to communicate with each other, potential medications can be delivered to the residents sooner, and interventions can be decided and taken, ultimately leading to improved health outcomes."
List of Texting Shortcuts for FaceBook - SMS - Chat Rooms: Shortcut list of the common acronyms and abbreviations used in chat rooms, SMS messages on cell phones, and instant messengers such as FaceBook messenger.
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