Background: When caring for patients, communication between health care providers is key. When communication and collaboration are optimized between members of the healthcare team, job satisfaction as well as patient care improves. Maintaining this communication in larger institutions can be a challenge and may rely on text-paging technology. In order to maintain efficient workflow and timely patient care, we attempted to change the previous culture of sending a “four digit” call back number only pages, to a culture of message text pages. Aim Statement: Within 10 months, 25% of the communication amongst nurses and pediatric residents would improve via text paging system by creating a standardized importance scale, and text-paging template. Methods: We surveyed residents and nurses to obtain their opinion on the effectiveness of text page communication. We tracked pages sent by nursing to residents from August 2014-September 2014, to obtain preliminary data, which showed a large proportion of text pages without messages, or priority level indicators (i.e. fyi, 911). We distributed a text-paging template to be placed on hospital badges and tracked pages from January 2015-June 2015. During this time we had discussion sessions with nursing on barriers to effective text paging communication. We sent surveys during the study period assessing nursing and resident feelings on the effectiveness of the text-paging template on communication. Outcome: An average of 37% informative pages sent prior to the study increased to over 70% after first PDSA cycle. Badge cards with the standardized level of importance scale for text pages were introduced prior to PDSA2 to improve our AIM. PDSA2 demonstrated sustained improvement, with the number of informative pages sent still at 70%. Limitations: We examined only a cross-section of messaging: between a select group of Inova Residents and nursing staff over a 10 month period. Evaluation over a longer period may reveal slightly different paging behaviors. Additionally, no pages to other residents, attending physicians, or ancillary staff were evaluated, thereby creating a potential selection bias. However, the goal of the study was to demonstrate that a standardized level of importance scale could quickly improve communication between nurses and residents and thus allow for better patient care Next Steps: Based on our experience with a standardized importance scale for pages, it seems there is an opportunity to improve the efficiency of communication further between hospital staff and residents in other departments. The study could also be expanded to include pages sent to attending physicians, consultants, and pharmacy staff as well. We demonstrated that meaningful improvements in clinical communication can occur with simple interventions like a standardized importance scale for text pages, and this should be tested in other clinical areas of the hospital.
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Council on Quality Improvement and Patient Safety Program| January 01 2018
Improving Interdisciplinary Communication via Text-paging Communication
Nicole Streeks, MD;
Tanikka Fevrier, DO;
Salma Haneef, MD;
Pediatrics (2018) 141 (1_MeetingAbstract): 127.
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Nicole Streeks, Tanikka Fevrier, Salma Haneef, Andrea Willis; Improving Interdisciplinary Communication via Text-paging Communication. Pediatrics January 2018; 141 (1_MeetingAbstract): 127. 10.1542/peds.141.1MA2.127
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