Original Article

Improving Interdisciplinary Provider Communication Through a Unified Paging System

Authors: Lauren Heidemann, MD, Christopher Petrilli, MD, Ashwin Gupta, MD, Ian Campbell, MD, Maureen Thompson, MSN, RN, Sandro Cinti, MD, David A. Stewart, MD

Abstract

Objectives: Interdisciplinary communication at a Veterans Affairs (VA) academic teaching hospital is largely dependent on alphanumeric paging, which has limitations as a result of one-way communication and lack of reliable physician identification. Adverse patient outcomes related to difficulty contacting the correct consulting provider in a timely manner have been reported.

Methods: House officers were surveyed on the level of satisfaction with the current VA communication system and the rate of perceived adverse patient outcomes caused by potential delays within this system. Respondents were then asked to identify the ideal paging system. These results were used to develop and deploy a new Web site. A postimplementation survey was repeated 1 year later. This study was conducted as a quality improvement project.

Results: House officer satisfaction with the preintervention system was 3%. The majority used more than four modalities to identify consultants, with 59% stating that word of mouth was a typical source. The preferred mode of paging was the university hospital paging system, a Web-based program that is used at the partnering academic institution. Following integration of VA consulting services within the university hospital paging system, the level of satisfaction improved to 87%. Significant decreases were seen in perceived adverse patient outcomes (from 16% to 2%), delays in patient care (from 90% to 16%), and extended hospitalizations (from 46% to 4%).

Conclusions: Our study demonstrates significant improvement in physician satisfaction with a newly implemented paging system that was associated with a decreased perceived number of adverse patient events and delays in care.

 

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: an insidious contributor to medical mishaps. Acad Med 2004;79:186-194.
 
2. Espino S, Cox D, Kaplan B. Alphanumeric paging: a potential source of problems in patient care and communication. J Surg Educ 2011;68:447-451.
 
3. Katz MH, Schroeder SA. The sounds of the hospital. Paging patterns in three teaching hospitals. N Engl J Med 1988;319:1585-1589.
 
4. Nguyen TC, Battat A, Longhurst C, et al. Alphanumeric paging in an academic hospital setting. Am J Surg 2006;191:561-565.
 
5. Quan SD, Wu RC, Rossos PG, et al. It’s not about pager replacement: an in-depth look at the interprofessional nature of communication in healthcare. J Hosp Med 2013;8:137-143.
 
6. Wu RC, Lo V, Morra D, et al. The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals. J Am Med Inform Assoc 2013;20:766-777.
 
7. Wong BM, Cheung CM, Dharamshi H, et al. Getting the message: a quality improvement initiative to reduce pages sent to the wrong physician. BMJ Qual Saf 2012;21:855-862.
 
8. Coiera E, Tombs V. Communication behaviours in a hospital setting: an observational study. BMJ 1998;316:673-676.
 
9. Wong BM, Quan S, Cheung CM, et al. Frequency and clinical importance of pages sent to the wrong physician. Arch Intern Med 2009;169:1072-1073.
 
10. Przybylo JA, Wang A, Loftus P, et al. Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow. J Hosp Med 2014;9:573-578.
 
11. Dingley C, Daugherty K, Derieg MK, et al. Improving patient safety through provider communication strategy enhancements. In: Henriksen K, Battles JB, Keyes MA, et al. eds. Advances in Patient Safety: New Directions and Alternative Approaches, Vol. 3: Performance and Tools. Rockville, MD: Agency for Healthcare Research and Quality; 2008.