Disruption caused by the house officer's bleep: a simple solution

Area of Science:

• Medical Sciences
• Healthcare Management
• Surgical Training

Background:

• The constant disruption from bleep (paging) systems significantly impacts the workflow and efficiency of surgical house officers.
• Previous research on the disruptive effects of paging systems in hospital settings is limited.
• Understanding and mitigating these disruptions is crucial for improving resident well-being and patient care.

Purpose of the Study:

• To evaluate the effectiveness of a new system for managing bleep calls to reduce disruptions for surgical house officers.
• To assess the impact of the intervention on the frequency and appropriateness of bleep calls.
• To determine the effect on house officer availability for patient care.

Main Methods:

• A 'control' week involved charting all bleep calls received by a surgical house officer, noting time, caller, and house officer activity.
• A 'test' week introduced a system where only the nurse in charge could initiate bleep calls, with tasks posted on a ward board.
• Both bleep call data and house officer involvement in patient care were recorded and compared between the two weeks.

Main Results:

• Inappropriate bleep calls from nurses decreased from 58% to 15% (p < 0.01).
• Total nurses' bleep calls before 5 pm fell by two-thirds (p < 0.01).
• House officer involvement in direct patient care increased as bleeps during these times decreased from 46% to 28%.

Conclusions:

• A simple policy change, designating the nurse in charge to handle bleep calls and utilizing a task board, significantly reduces disruptions for surgical house officers.
• This intervention leads to a substantial decrease in unnecessary paging and improves house officer availability for patient care.
• The findings suggest a practical and effective strategy for enhancing the daily workflow and reducing interruptions in surgical residency programs.