Eric Martin, MD*1;Anunta Virapongse, MD, MPH2;Madelin Adames, RN, MSN3;Matthew Campo, MHA4;Ashley LaBree, RN3;Marcee Paul, MBA, BSN, RN-BC3 and Aimee Zak, RN3, (1)University of Colorado, Aurora, CO, (2)University of Colorado Anchutz Medical Campus, Denver, CO, (3)University of Colorado Hospital, Aurora, CO, (4)Universtiy of Colorado Health, AURORA, CO

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 10

Categories: Communication, Innovations Abstracts

Keywords: , , ,

Background: Due to low cost, dependability, and familiarity, one-way alphanumeric paging continues to be a commonly used method of in-hospital communication. However, lack of urgency indicators has been cited as a key limitation. To address this issue, an Interdisciplinary Communication Improvement Taskforce (In-CITe) at an academic medical institution adopted a Priority Structured Paging (PSP) system whereby nurses could convey their level of urgency by tagging pages with a numeric priority indicator. Successful piloting of PSP on a single medicine floor prompted broader implementation.

Purpose: Deploy across multiple nursing units a PSP system that communicates page urgency, is easy to understand, remember, use, and requires minimal cost outlays or alteration to existing information communication technology.

Description: Geriatric, bone marrow transplant, oncology, step-down, pulmonary, and transplant nursing units agreed to be PSP expansion sites. During a pre-intervention phase, nurses blinded to the intervention collected baseline data including page response times and their perceived level of concern (low, medium, high, or emergent). A pre-intervention survey was then completed by nurses and providers. Next, an intervention phase began with In-CITe members informing and reminding nurses at every shift change huddle to tag sent pages with a numeric urgency indicator (*3, *2, *1, *911, corresponding to low, medium, high, and emergent urgencies) based on their clinical judgement, and record pages as done during the pre-intervention phase. Receiving providers were educated about different priority tiers and response time expectations by flyers and emails. The intervention phase concluded after two weeks and was followed by a nurse and provider survey. Survey data demonstrated high nursing and provider PSP usage (91.6%; n=309), ease of use (96.7%; n=183 RNs), and understanding (96.5%; n= 283). Nursing verified PSP’s functionality by demonstrating a preference (91.3%; n=183 RNs) and willingness (95.6%; n=183 RNs) to continue its usage. RNs and providers agreed/strongly agreed that PSP provided the ability to communicate urgency and improved the effectiveness of both numeric (p<0.0000, p<0.0000) and text (p<0.0000, p=0.0200) paging. Twelve months after data collection, PSP usage continues.

Conclusions: Nurses are willing to use current technology in a new manner, without repetitive prompting, to communicate urgency to providers. PSP is a low tech, low cost paging scheme that is easy to use, understand, and effectively provides nursing staff the ability to communicate urgency when using alphanumeric pagers. Additionally, PSP is easily implemented and scaled, and improves the perceived effectiveness of alphanumeric paging. Such a system could be easily applied to alternative information communication technologies in the future.

To cite this abstract:

Martin, E; Virapongse, A; Adames, M; Campo, M; LaBree, A; Paul, M; Zak, A . HELP ME HELP YOU: A LOW-TECH, LOW-COST SOLUTION TO IMPROVING COMMUNICATION. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 10. Journal of Hospital Medicine. 2017; 12 (suppl 2). Accessed September 19, 2019.

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