Appropriate use of pagers in a New Zealand tertiary hospital

To identify the appropriateness of calls to on-call house officers in a major tertiary teaching hospital.

A prospective observational study was conducted at Auckland City Hospital over the months of June, July, and August 2004. Fourteen house officers from a range of medical and surgical services categorised calls received while on-call after-hours into one of three groups: 'appropriate and urgent'; 'appropriate but not urgent'; and 'inappropriate'.

844 calls were recorded and categorised, with approximately even distribution between medical services (431 calls) and surgical services (413 calls); 30% of calls were deemed clinically appropriate and required a response within 1 hour; 53% of calls were deemed clinically appropriate but did not require a response within an hour; while 17% of calls were deemed inappropriate.

The most important function an on-call house officer performs is responding to urgent medical situations. Frequent interruptions mean that house officers may become less efficient and more prone to making mistakes. The majority of calls received by on-call house officers did not need immediate responses and would have been better communicated via a less intrusive system such as text-messaging or the keeping of a non-urgent jobs list. If house officers were paged more appropriately then they would be interrupted less frequently and would be able to provide safer, more efficient, and timelier patient care.