Abstract
Background
Studies on medicine wards have shown that numeric pages can be disruptive of workflow
and patient care. We created a quality improvement program among surgical ward nurses
and residents and hypothesized that a text-based, urgency-stratified initiative would
improve communication at no detriment to patient care.
Methods
Surgery residents recorded preintervention data for 1 mo including number of total
pages, text pages, and numeric pages received from surgical floors. Nurses and residents
completed surveys to assess preintervention satisfaction with communication, responsiveness,
and workflow. Nurses were then instructed to use text paging for nonurgent issues.
Paging data were again recorded for 1 mo, surveys repeated, and patient safety and
satisfaction data collected. Primary endpoints evaluated included patient safety and
satisfaction data. Secondary endpoints included communication satisfaction of nurses
and residents.
Results
After text paging implementation, 40.1% of nonurgent pages sent from nurses to resident
physicians were alphanumeric texts versus only 17.9% before implementation (P < 0.0001). There was a 19.5% reduction in the number of nonurgent numeric pages sent
(P < 0.0001). Overall, 70% of nurses responded postintervention that text paging was
the preferred method of contacting a physician and that the text paging initiative
improved efficiency. After implementation, 62% of nurses thought that overall communication
with clinicians improved. In addition, there was no change in patient safety issues
or patient satisfaction.
Conclusions
Our text paging initiative for all nonurgent pages from nurses to residents improved
physician–nurse workflow and communication on the surgical ward with no decrease in
patient satisfaction or safety.
Keywords
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References
The Joint Commission. Sentinel Event Data Root Causes by Event Type 2004–2013. Available at: http://www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2Q2013.pdf.
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Article info
Publication history
Published online: February 20, 2017
Accepted:
February 14,
2017
Received in revised form:
January 2,
2017
Received:
December 1,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
