Nursing‐Physician Paging Communication: How Effectively Is It Working?

Background:

The care delivery in a teaching hospital depends on effective communication amongst multiple healthcare providers. Adverse outcomes and patient care delays are often caused by communication failure. Several hospitals utilize a paging system to communicate messages to their healthcare providers, varying from minor to critical. Frequent physician rotation changes can lead to communication barriers and delays in patient care. In a teaching hospital in the Texas Medical Center, nurses utilize a numeric paging system for physicians; call schedules are available online and via page operator.

Methods:

An electronic survey was sent to all registered nurses caring for medicine patients. The survey focused on nursing experiences when contacting a physician regarding patient care using a paging system.

Results:

The survey was sent to 424 registered nurses (RNs) and 115 responded (response rate 27.1%). The utilization of the page operator for contacting physicians was 81.7%. RNs utilized wireless phone numbers as their call back number 93.9% of the time. The average physician call back time was reported to be within 15 minutes (60.7%), 16‐30 minutes (34.8%), and 31‐60 minutes (4.5%). RNs found the first physician contacted was able to address the concern 49.6% of the time. Average of 1.5 additional physicians (range 1‐4) were contacted to address patient care concern when the first physician was unable to assist. Nurses reported the physicians took longer than 15 minutes to address patient care needs for 53.6% of pages which impacted patient care delivery (95.6% of nurses reporting) especially on weekends, outside the hours of 7am‐5pm and during resident conference times.

Conclusions:

The study showed that nursing‐physician paging communication was not effective. Nursing frequently has to make several calls before a patient care need is resolved which results in patient care delays. New communication protocols and methods should be evaluated to improve collaborative efforts between nurses and physicians in patient care delivery.