M. Janko1, M. G. Noujaim2, K. F. Angell1, J. Hill1, J. Kalil1, S. Steele3 3Case Western Reserve University School Of Medicine,Colorectal Surgery,Cleveland, OH, USA 1Case Western Reserve University School Of Medicine,Vascular Surgery,Cleveland, OH, USA 2University Of Massachusetts Medical School,School Of Medicine,Worcester, MA, USA
Introduction: Medical staffs rely on paging to communicate patient safety concerns and updates in the hospital. Studies on medical wards have shown that numeric callback pages can be both disruptive and cryptic. In contrast, alphanumeric text paging using a hospital-issued pager on medicine wards has been shown to reduce disruptive pages and raise satisfaction scores among healthcare professionals. Here we report a quality improvement initiative among nurses and surgical interns involving text paging to communicate urgent and non-urgent issues on a surgical ward.
Methods: Surgery residents recorded pre-intervention data for 1 month including average patient census, number of urgent and non-urgent pages received from surgical floors, number of text and traditional call-back pages from surgical floors, total number of pages received and major adverse events. Surgical nurses and residents completed surveys to assess pre-intervention satisfaction, responsiveness and workflow. Surgical nurses were then instructed to utilize text-paging to communicate with residents for non-urgent issues. Urgent communications continued to be communicated with traditional numeric callback pages. Paging data was again recorded for 1 month and surveys were repeated. Statistical analysis using Chi-squared and student’s t-tests were used to compare pre- and post-intervention results.
Results: After text paging implementation 40.2% of non-urgent pages sent from nurses to resident physicians were alphanumeric texts vs. only 17.9% before implementation (P < 0.0001), and there was a 19.5% reduction in the number of non-urgent numeric callback pages sent from nurses to physicians (P < 0.0001). 70% of nurses surveyed post-implementation responded alphanumeric text paging was the preferred method of contacting a physician. 70% of nurses thought text paging initiative improved efficiency in triaging and responding to pages. After implementation, 62% of nurses thought that overall communication with responding clinicians improved. Furthermore, residents reported increased satisfaction, improved workflow, and decreased educational interruptions with text paging.
Conclusion: We successfully implemented a free web-based text paging initiative for all non-urgent pages from nurses to residents that has improved physician-nurse workflow and communication on the surgical wards without an increase in adverse events.
