Objective: To assess the effects of using a smartphone-based push-to-talk (PTT) application on communication, safety, and clinical performance of emergency department (ED) workers during the COVID-19 outbreak. 

Design: An observational, cross-sectional study. 

Setting: ED in an academic medical center. 

Participants: All ED staff members, including physicians (consultants, specialists, residents, and interns), nurses, emergency medical services staff, technicians (X-ray), and administration employees. Interventions: Eligible participants (n=128) were invited to fill out an online questionnaire 30 days after using a PTT application for sharing instant voice messages during the COVID- 19 outbreak. Main Outcome Measures: Self-reported data related to communication, implementation of personal protective measures, and clinical performance at the ED were collected and analyzed on a 5-item Likert scale (from 5 [strongly agree] to 1 [strongly disagree]). Also, the proportions of favorable responses (agree or strongly agree) were calculated. 

Results: Responses of 119 participants (51.3% females, 58.8% nurses, and 34.5% physicians; 90.4% received at least one notification per day) were analyzed. The participants had favorable responses regarding all domains of communication (between 63.0% and 81.5%), taking precautionary infection control measures (between 49.6% and 79.0%), and performance (between 55.5% and 72.3%). Receiving fake and annoying alerts and application breakdowns were the lowest perceived limitations (between 12.5% and 21.0%). 

Conclusion: The assessed PTT application can be generalized to other departments and hospitals dealing with patients with COVID-19 to optimize staff safety and institutional preparedness. Keywords: communication, emergency department, pandemic, COVID-19