SHM Converge Scientific Abstract ePoster Gallery-Less Pajama Time and More Sleep: Improving Inpatient Text Communication

Pdf Summary

This quality improvement project addressed “pajama time,” the after-hours EMR work that can contribute to physician burnout. At a large urban academic medical center, internal medicine residents used Epic Secure Chat (ESC) for inpatient communication, and many were responding to messages outside scheduled work hours.  <br /><br />A needs assessment of 62 residents found that 61% believed after-hours EMR use harmed their quality of life, and 31% reported spending 5 or more hours per week on the EMR outside duty hours. To reduce this burden, the team implemented two Plan-Do-Study-Act cycles: first, a new sign-in/sign-out workflow for EMR messaging at shift change; second, individualized alerts and EMR tips for residents with high pajama time. They also reviewed 50 after-hours ESC messages to understand why they were being sent.  <br /><br />The analysis suggested that off-duty messages were mainly related to ongoing clinical care, and that trainees had particular difficulty early in the academic year. The intervention was associated with reduced EMR pajama time among residents. The authors conclude that structured EMR signout processes, along with targeted education and reinforcement, can help decrease after-hours texting and improve trainee wellbeing.

Asset Subtitle

Vinh-Tung P. Nguyen

Meta Tag

Author List Benjamin Dempsey, Beth Raucher, Julie Pearson, Nathaniel Ash, Sharanya Iyer, Sheno De Britto, Vinh-Tung P. Nguyen

Category Innovations

Concept Off-duty EMR Messaging

Concept Pajama Time

Concept Burnout

Concept Inpatient Physician

Concept Quality of Life

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai

Presenting Author Vinh-Tung P. Nguyen

Track Technology in Hospital Medicine

Keywords

pajama time

EMR

physician burnout

after-hours work

Epic Secure Chat

resident physicians

quality improvement

sign-out workflow

trainee wellbeing

PDSA cycles

Off-duty EMR Messaging

Pajama Time

Burnout

Inpatient Physician

Quality of Life