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Turning a new “page”: ways to decrease the number of pages after hours without compromising patient care

Annette Schröder¹, Walid A. Farhat¹, Darius J. Bägli¹

¹From the Department of Urology and Pediatric Urology, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany (Schröder); and the Department of Urology, Hospital for Sick Children, Toronto, Ont. (Farhat, Bägli, Lorenzo, Koyle).

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|March 28, 2020

Summary

Reducing non-urgent pages to pediatric urology staff significantly decreased after-hour pages by 70%. Implementing consistent parent education and alternative communication channels improved patient care and reduced physician fatigue.

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Area of Science:

Pediatric Urology
Healthcare Communication
Physician Workflow Optimization

Background:

After-hours pages disrupt staff sleep and cause fatigue.
Not all pages require immediate response, impacting efficiency.
Identifying and reducing unwarranted pages is crucial for well-being and patient care.

Purpose of the Study:

To identify medically unnecessary pages to the Department of Pediatric Urology.
To implement strategies for reducing these non-urgent pages.
To evaluate the effectiveness of interventions on page volume and patient care.

Main Methods:

Documented and assessed medical necessity of all pages over two months.
Analyzed reasons for inappropriate pages.
Implemented interventions including standardized parent teaching and alternative communication methods.
Re-evaluated page volume one year later to assess intervention efficacy.

Main Results:

Initially, approximately 50% of in-hospital pages were not medically urgent.
Common reasons for unwarranted pages included inconsistent parent education and poor triaging.
Post-intervention, page volume decreased by 70% within one year.
Interventions focused on streamlining communication and parent education.

Conclusions:

Physician availability is essential, but communication must be appropriate.
Consistent teaching and alternative communication channels reduce after-hours pages.
Optimizing communication strategies enhances patient care and physician well-being.