Design and Integration of a Texting Tool to Keep Patients’ Family Members Updated During Hospitalization: Clinicians’ Perspectives

Courtenay R. Bruce, Ashleigh Kamencik-Wright, Natalie Zuniga-Georgy, Thomas M. Vinh, Hema Shah, Jamie Shallcross, Charlie Giammattei, Colleen O’Rourke, Mariana Smith, Lindsey Bruchhaus, Yashica Bowens, Kimberley Goode, Lee Ann Arabie, Katherine Sauceda, Majeedah Pacha, Sandra Martinez, James Chisum, R. Benjamin Saldaña, S. Nicholas Desai, Melina AwarThomas R. Vernon

Research output: Contribution to journalArticlepeer-review


An important gap in the literature is how clinicians feel about patient-centered technologies and how clinicians experience patient-centered technologies in their workflows. Our goal was to identify clinician users’ perspectives on facilitators (pros) and barriers (cons) to using 1 digital texting innovation to promote family centered care during patients’ hospitalizations. This qualitative study was conducted at a tertiary care center in Houston, consisting of 7 hospitals (1 academic hospital and 6 community hospitals), involving analyzation of 3 focus groups of 18 physicians, 5 advanced practice providers, and 10 nurse directors and managers, as well as a content analysis of 156 real-time alerts signaling family dissatisfaction on the nursing unit/floor. Thematic analysis methods were used. We selected these participants by attending their regularly scheduled service-line meetings. Clinician feedback from focus groups resulted in 3 themes as facilitators: (a) texting platforms must be integrated within the electronic medical record; (b) texting reduces outgoing phone calls; (c) texting reduces incoming family phone calls. Clinician feedback resulted in 3 themes as barriers: (a) best practice alerts can be disruptive; (b) real-time alerts can create hopelessness; and (c) scale-up is challenging. The analyzation of facilitators (pros) and barriers (cons) pertains only to the clinician's feedback. We also analyzed real-time alerts signaling family dissatisfaction (defined as “service recovery escalation” throughout this manuscript). The most common selection for the source of family dissatisfaction, as reflected through the real-time alerts was, “I haven’t heard from physicians enough,” appearing in 52 out of 156 alerts (33%). The second most common selection for the source of dissatisfaction was “perceived inconsistent or incomplete information provided by team members,” which was selected in 48 cases (31%). Our findings indicate that clinicians value inpatient texting, not only for its ability to quickly relay updates to multiple family members with 1 click, but also because, when used intentionally and meaningfully, texting decreases family phone calls.

Original languageEnglish (US)
JournalJournal of Patient Experience
StatePublished - Jan 1 2023


  • MHealth technology
  • effectiveness
  • family centered care
  • family decision making
  • mHealth interventions
  • patient activation
  • patient engagement
  • patient experience
  • patient safety
  • patient-centered care
  • quality improvement

ASJC Scopus subject areas

  • Leadership and Management
  • Health(social science)
  • Health Policy


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