Carlile Narath, Rhatigan Joseph J, Bates David W
General Internal Medicine, Brigham And Women's Hospital, Boston, Massachusetts, USA.
Division of Global Health and Social Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
BMJ Qual Saf. 2017 Jan;26(1):24-29. doi: 10.1136/bmjqs-2015-004587. Epub 2016 Jan 6.
Paging still represents an important form of communication within hospitals, but it results in interruptions, and other more modern approaches could be superior. This study aims to describe how paging is currently used in an academic medical centre, including the frequency, type, urgency and sender of pages, so that improvements in communication can be better informed.
In order to understand what communication needs paging fulfils in a modern academic medical centre, we analysed a database of 1252 pages sent to internal medicine residents within an academic medical centre. We assessed all pages from 3 separate general medicine rotations over a total of 56 days encompassing 602 h.
Residents were paged an average of 22.4 times per day, with a maximum of 50 pages per day. Most pages were deemed clinically relevant (76%) and important (76%) to patient care. Overall, 59% of pages required a response. A mean of 7.7 pages were sent per patient, up to a maximum of 70 pages for one patient. Nurses (28%), consultants (16%) and the clinical laboratory (15%) were responsible for the majority of pages. Almost all pages from nurses (82%) and consultants (82%) required a response. Regionalised services had significantly fewer pages per day than non-regionalised services (19 vs 37, p≤0.00001).
Paging remains widely used for communications within hospitals about patient care. Although the majority of pages were judged to be clinically relevant and important, they frequently required a response potentially leading to interruptions in workflow, and communication waste. Paging rate and volume has not decreased in 25 years despite significant penetration of newer technologies. For the majority of current uses of pages, we believe other approaches may now be more appropriate. Regionalisation significantly reduces the number and urgency of the pages.
传呼仍是医院内一种重要的通讯方式，但会导致干扰，其他更现代的方法可能更具优势。本研究旨在描述目前学术医疗中心如何使用传呼，包括传呼的频率、类型、紧急程度和发送者，以便为改善通讯提供更充分的信息。
为了解传呼在现代学术医疗中心满足了哪些通讯需求，我们分析了发送给学术医疗中心内科住院医师的1252次传呼的数据库。我们评估了来自3个不同普通内科轮转的所有传呼，时间跨度为56天，共计602小时。
住院医师平均每天接到22.4次传呼，最多一天接到50次传呼。大多数传呼被认为与临床相关（76%）且对患者护理很重要（76%）。总体而言，59%的传呼需要回复。每位患者平均收到7.7次传呼，一名患者最多收到70次传呼。护士（28%）、会诊医生（16%）和临床实验室（15%）发出的传呼占大多数。几乎所有护士（82%）和会诊医生（82%）发出的传呼都需要回复。与非区域化服务相比，区域化服务每天的传呼次数明显更少（19次对37次，p≤0.00001）。
传呼在医院内关于患者护理的通讯中仍被广泛使用。尽管大多数传呼被判定与临床相关且重要，但它们经常需要回复，这可能导致工作流程中断和通讯浪费。尽管新技术已大量普及，但传呼率和传呼量在25年里并未下降。对于目前传呼的大多数用途，我们认为现在其他方法可能更合适。区域化显著减少了传呼的数量和紧急程度。
