Communication failure is the most common cause of preventable disability or death in the hospital. Accurate and efficient communication is the cornerstone of multidisciplinary health care. Multiple clinicians and other personnel need to identify a patient's primary inpatient provider (PIP) to deliver quality health care. Systems to identify the PIP are often inaccurate: 1 study found up to 14% of pages are sent to the wrong physician and that 47% of these were urgent or emergent. A survey of nurses within our institution revealed that a significant portion of pages sent were not reaching the PIP and that the majority of nurses were either somewhat or extremely frustrated with the paging system. They reported that the communication gaps had direct effects on patient care, leading to decreased patient satisfaction, delay in adequate pain control, and delay in discharge. We found that PIPs were often inaccurately identified, as they were based on schedules submitted by departments frequently weeks to months in advance. In this era of frequent hand‐offs, an accurate PIP tracking system that can correct in real time is critical to hospital communication and patient safety.
We embedded a Web‐based PIP identification and text paging system in the electronic medical record (EMR). We implemented the tool with the aim of improving patient safety and satisfaction by decreasing errors related to communication failure.
CORES is an internally developed EMR tool used by all inpatient hospital services to identify all the patients they follow. Users print rounding and hand‐off lists with key information about those patients. In collaboration with IT professionals, we modified this tool to enable providers to identify themselves or another team member as the primary contact for their patients, accurately establishing this critical link between provider and patient. Once established, this PIP is then displayed in the electronic chart. Anyone with access to the patient's chart can now identify the PIP and easily send an alpha‐numeric message with a single click. In addition to the PIP, consulting teams can also display contact information. Important to work flow, the system provides an efficient method to sign out and hand off on‐call responsibilities that is acceptable and conducive to a clinician's busy schedule.
We developed and deployed a paging system that directly links providers to their patients. This system is novel because providers directly identify themselves as responsible for their patients, and this information is then publicly available in the EMR, markedly improving accuracy of identification. The system is user friendly and provides a way for all health care personnel caring for a patient to communicate with the PIP directly from the EMR. Our hope is that it will lead to decreased errors and improved patient safety and patient satisfaction.
M. Zaros ‐ none
To cite this abstract:Zarso M, Fletcher G, White A, Eaton E, Stone D. Who's Taking Care of This Patient? A Novel Provider Tracking and Paging System. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 219. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/whos-taking-care-of-this-patient-a-novel-provider-tracking-and-paging-system/. Accessed September 17, 2019.