The quick response code: A treatment for COVID-19 information overload

Intro/Background: One of many challenges created by COVID-19 is the need for unusually rapid dissemination and uptake of new information by emergency department teams. As our understanding of COVID-19 evolves, it is accompanied by rapid progression of new procedures and protocols related to infection control, testing indications, admissions policies, and patient flow. Effective communication around changes is particularly important for promoting resilience during crises, and having staff adhere to current policies is crucial for patient safety. Purpose/Objective: Our emergency department sought innovative, behavioral-science informed methods for effective and efficient information dissemination during the pandemic. Our initial communications strategies were time and resource intensive, which became untenable as the crisis continued beyond its first few months. New solutions needed to meet four criteria: 1) Easy access for staff 2) Up-to-date information 3) Uncomplicated maintenance for the communications team 4) Rapid adaptability for potential future changes. Methods: We created a simple website with the latest ED-specific COVID-19 updates linked to a unique QR code for staff to access in real time during shifts. QR code posters were placed in strategic locations throughout clinical areas and small QR code stickers were placed on every computer in the ED. The website had separate links for providers and nurses with role-specific information. These pages were maintained respectively by a physician and nurse lead. Outcomes (if available): From June through October 2020, the QR codes were scanned 433 times by 294 distinct users. 47% of these scans were of computer stickers and 53% were of posters. Some users re-scanned the code each time they wanted to access the content, while others appeared to bookmark the website on their mobile device. The site was accessed most frequently in June and July following initial implementation, but use remained durable over subsequent months. Summary: The COVID-19 pandemic has created rapid changes within emergency departments, requiring novel communication methods for keeping staff informed. We sought a behavioral science-informed strategy for effective information dissemination that was easy for both staff to access and for ED leaders to maintain. A QR Code solution met our delineated criteria. With QR code posters in key locations and stickers on every ED computer linked to a simple COVID-19 website, staff are able to access the most recent and pertinent updates in real time during their shifts. The website has separate pages for providers and nurses, providing role-specific guidance on infection control strategies, testing pathways, admissions policies, and treatment guidelines. The site is easy to maintain and is administered by a physician and nurse lead who are also responsible for leading our COVID-19 operational efforts. This ensures that the site always has the most up to date information available. The posters and stickers we designed utilize the behavioral principles of ease and salience;the design acknowledges the rapidly changing protocols, offers help, and includes just one simple call to action-to scan. They also uses bright colors and strategic formatting to capture attention. The QR codes were scanned over 400 times between June and October with durable usage over time. Staff expressed appreciation of the simple, streamlined access point for COVID-19 updates, and scans were evenly split between the posters and the stickers. The need for e-mail and in-person communications related to COVID-19 decreased substantially because of the QR code strategy, which was beneficial for both staff and ED administrative leadership. We suspect the QR platform may also prove useful for providing other types of updates to ED staff in the future, or as a way for staff to easily review information related to other rarely used procedures and protocols.