Division of General Internal Medicine, University Health Network, Toronto, Canada.
J Hosp Med. 2010 Nov-Dec;5(9):553-9. doi: 10.1002/jhm.775.
Communication between clinicians is hampered by the frequent difficulty in reaching the most responsible physician for a patient as well as the use of outdated methods such as numeric paging. The aim of this study was to evaluate the use of smartphones to improve communication on internal medicine wards.
At the Toronto General Hospital, residents were provided with smartphones. To simplify reaching the most responsible resident for a patient, a smartphone designated as "Team BlackBerry" was also carried by each senior resident and then passed to the resident covering the team at night and on weekends. Nurses were able to send email messages or call smartphones directly.
There were on average of 9.1 incoming calls, 6.6 outgoing calls, 14.3 received emails, and 2.8 sent emails per day to each Team BlackBerry. Team BlackBerrys received up to 35 calls and 57 emails per day. Residents strongly preferred the smartphones over conventional paging with perceived improvements in all items measured and felt that it improved efficiency and communication. Although nurses perceived a reduction in the time required to contact a physician (27.6 vs. 11 minutes P < 0.001), their overall satisfaction with physician's response time for urgent issues did not improve significantly.
When smartphones were used for clinical communication, residents perceived an improvement in communication with them. Residents strongly preferred emails as opposed to telephone calls as the prime method of communication. Further objective evaluation is necessary to determine if this intervention improves efficiency and more importantly, quality of care.
临床医生之间的沟通受到频繁难以联系到最负责的患者医生以及使用过时方法(如数字寻呼)的阻碍。本研究旨在评估使用智能手机改善内科病房的沟通效果。
在多伦多总医院,住院医师配备了智能手机。为简化联系最负责的住院医师,每位高级住院医师还携带一部名为“Team BlackBerry”的智能手机,并在夜间和周末将其交给负责该团队的住院医师。护士可以直接发送电子邮件或打电话给智能手机。
每个 Team BlackBerry 每天平均有 9.1 个来电、6.6 个去电、14.3 封收到的电子邮件和 2.8 封发出的电子邮件。Team BlackBerry 每天最多可接收 35 个电话和 57 封电子邮件。住院医师强烈偏好智能手机而不是传统的寻呼机,认为所有测量项目都有所改善,并认为它提高了效率和沟通效果。尽管护士认为联系医生所需的时间减少了(27.6 分钟与 11 分钟,P<0.001),但他们对医生对紧急问题响应时间的整体满意度并没有显著提高。
当使用智能手机进行临床沟通时,住院医师认为与医生的沟通得到了改善。住院医师强烈偏好电子邮件而不是电话作为主要沟通方式。需要进一步的客观评估来确定这种干预是否能提高效率,更重要的是提高护理质量。