Hospital Text-Paging Communication as a Surgical Quality Improvement Initiative

Abstract Background Studies on medicine wards have shown numeric pages can be disruptive of workflow and patient care. We created a quality improvement program among surgical ward nurses and residents and hypothesized that a text-based, urgency-stratified initiative would improve communication at no detriment to patient care. Methods Surgery residents recorded pre-intervention data for one month including number of total pages, text pages, and numeric pages received from surgical floors. Nurses and residents completed surveys to assess pre-intervention satisfaction with communication, responsiveness, and workflow. Nurses were then instructed to utilize text-paging for non-urgent issues. Paging data were again recorded for one month, surveys repeated, and patient safety and satisfaction data collected. Primary endpoints evaluated included patient safety and satisfaction data. Secondary endpoints included communication satisfaction of nurses and residents. Results After text paging implementation, 40.1% of non-urgent pages sent from nurses to resident physicians were alphanumeric texts vs. only 17.9% before implementation (P < 0.0001). There was a 19.5% reduction in the number of non-urgent numeric pages sent (P < 0.0001). Overall, 70% of nurses responded post-intervention that text paging was the preferred method of contacting a physician and that the text paging initiative improved efficiency. After implementation, 62% of nurses thought that overall communication with clinicians improved. In addition, there was no change in patient safety issues or patient satisfaction. Conclusion Our text paging initiative for all non-urgent pages from nurses to residents improved physician-nurse workflow and communication on the surgical ward with no decrease in patient satisfaction or safety.