The Impact of Text Pager Implementation on an Urban Hospital Surgical Service

Jennifer A Montes, MD, MPH, Deo Davis, Sam Johnson, Robert A Andrews, MD, Yuriy Dudiy, MD. North Shore LIJ Lenox Hill Hospital

INTRODUCTION –Numerical pagers are the current modality used to facilitate non-verbal communication between nurses and physicians. However, they are hindered by their inability to convey information beyond a callback number leaving the recipient uninformed about the nature of the page, its urgency or who generated the page. To address these issues, technological advancements such as text pagers have been developed to increase the efficacy and quality of communication amongst medical professionals. Drawing on this research, this study was designed to evaluate the effects of implementing alphanumeric pagers on the surgical service of an urban hospital. Specifically, to see if alphanumeric pagers decrease the number of pages and interruptions, increase quality of communication and improve general quality of life.

METHODS AND PROCEDURES – This study was conducted utilizing a pre-intervention/post-intervention survey design at a 652 bed urban facility to observe the effectiveness of using alphanumeric pagers in comparison to traditional pagers. Thirteen first level surgical team members (STM) were surveyed prior to the implementation of the Alpha pagers, and then again following the 5-month integration period. The data was collected and entered into an excel spreadsheet both at baseline and five months after the implementation of the alpha-numeric pager system. Statistical analysis was performed using the SPSS statistical package (Versions 20.0, SPSS, Chicago, Illinois). Paired t-test was used to compare the mean before and after employment of alphanumeric pagers.

RESULTS – An analysis of pre-intervention data was compared with post intervention data with regard to several factors including: number of pages and interruptions per day, overall communication efficacy and general quality of life. Pre-intervention, pages received per day averaged 12.23 pages for existing order renewals and 4.23 pages post-intervention, which was a decrease of 65.41% (p=.063). An average of 16.46 new non-emergent pages were received per day pre and an average of 8.62 post, a decrease of 62.58% (p=.076) The number of interruptions was assessed by STM on a scale of 5 being very often and 1 being never. Pre-intervention STM members ranked frequency of interruptions at an average of 3.23 per day while post-intervention was scaled at 2.38, a decrease of 26.19% (p=.699). Lastly, an overall improvement was observed in interdepartmental communication when STM were asked to rank the quality of communication on a scale of 10 being excellent and 1 being poor. Pre-intervention, STM rated communication efficacy at 6.15, however post-intervention STM recorded communication to be 7.39, an improvement of 20.00%. Using the same scale, the general quality of life according to the STM improved 18.18% (p=.308).

CONCLUSION– The data obtained from this study indicates that overall alphanumeric pagers provide an efficient method of communication having reduced the number of pages, increasing the quality of communication and improving the general quality of life. To reach definitive conclusions regarding pager interruption, surveys should be redistributed, with detailed questions, following a longer integration period. Limitations of the study include small setting, short integration period and subjective surveys. Though there were limitations, the results acquired show that alphanumeric pagers have improved communication overall.

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