Original Article

Does the Addition of Vocera Hands-Free Communication Device Improve Interruptions in an Academic Emergency Department?

Authors: Amy A. Ernst, MD, FACEP, Steven J. Weiss, MD, MS, Jeffrey A. Reitsema, MD


Objective: Emergency department (ED) interruptions occur frequently. Recently, a hands-free communication device (HCD; Vocera) was added to the population of communications devices (a cellular telephone and a pager) in our ED. The research purpose was to determine whether this addition improved interruption times and our hypothesis was the device would decrease length of interruptions.

Methods: This was a prospective cohort study of interruptions in an academic ED level 1 trauma center before and after introduction of an HCD. Interruptions were defined a priori and based on previous literature. We studied a convenience sampling of shifts. Length of interruption time was recorded. Three investigators collected interruption data, including nine different ED attendings.

Results: Of 511 interruptions, there were no significant differences in types of interruptions pre- versus post-HCD. Before HCD use, we collected 40 hours of data with 65 interruptions (mean 1.6/hour). Post-HCD, 180 hours of data were collected with 446 interruptions (mean 2.5/hour). There was a significant difference in length of time of interruptions, with an average of 9 minutes pre-HCD versus 4 minutes post-HCD (P = 0.012 diff 4.9; 95% confidence interval 1.8–8.1). HCD calls were significantly shorter than non-HCD calls (1 vs 5 minutes; P < 0.001). Comparing data collectors for type of interruption during the same 4-hour shift resulted in κ = 0.73.

Conclusions: The addition of Vocera HCD may improve interruptions by shortening call length.

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