Implementation of Toxicall: impact on documentation

On January 1, 1999, the Washington Poison Center implemented Toxicall; 6 mo later we measured its impact on time devoted by staff for telephone interchange, information retrieval from other than Poisindex, and documentation, and to compare it with prior studies of our conventional paper-pencil system. Previous "time and motion" studies over the past decade, using random alarm devices (Devilbiss Electronics) provided data for comparative purposes. We developed a computer-based alarm system for timing and station selection and for recording observed behaviors. Over a 6-w period, 211 calls were analyzed; the percentage of time involved for each call was compared to a 1993 study. An increased, rather than anticipated decreased, documentation effort was observed (p< 0.05), but staff participation in activities other than those listed fell dramatically suggesting increased staff efficiency. Although documentation efforts consume so much time, Toxicall provided the non-debatable benefit of eliminating illegible staff handwriting!