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Distinguishing urgent from non-urgent communication is critical. We aimed to understand how hospital staff choose what communication technologies to use. A mixed methods study was conducted with four focus groups, with staff working on postpartum care units, and log data from a hands-free communication system was analyzed. We found that urgent communications were appropriate for the hands-free device, with less urgent communications sent through secure chat in the electronic health record. Exceptions included when the intended recipient was in the operating room and during sensitive discussions. The most common duration of calls on the hands-free device was 16--60 seconds, with few more than 5minutes. The most frequent reason for incomplete calls was the user not logging in (36%), which could be reduced by eliminating logging in and training. We recommend an interruptive communication technology for urgent information and an electronic health record chat for less urgent information that does not require an immediate response. We recommend forwarding and sending calls to a hospital-provided cellphone from the hands-free communication system for provider roles that do not align with the intended workflow for hands-free communications. [ABSTRACT FROM AUTHOR]

Objectives Effective communication amongst healthcare workers simultaneously promotes optimal patient outcomes when present and is deleterious to outcomes when absent. The advent of electronic health record (EHR)-embedded secure instantaneous messaging systems has provided a new conduit for provider communication. This manuscript describes the experience of one academic medical center with deployment of one such system (Secure Chat). Methods Data were collected on Secure Chat message volume from June 2017 to April 2023. Significant perideployment events were reviewed chronologically. Results After the first coronavirus disease 2019 lockdown in March 2020, messaging use increased by over 25 000 messages per month, with 1.2 million messages sent monthly by April 2023. Comparative features of current communication modalities in healthcare were summarized, highlighting the many advantages of Secure Chat. Conclusions While EHR-embedded secure instantaneous messaging systems represent a novel and potentially valuable communication medium in healthcare, generally agreed-upon best practices for their implementation are, as of yet, undetermined. [ABSTRACT FROM AUTHOR]

It is unclear whether previously developed frameworks for effective consultation apply to requests initiated by alphanumeric text page. We assessed a random sample of 210 text paged consult requests for communication of previously described 'essential elements' for effective consultation: reason for consult, level of urgency and requester contact information. Overall page quality was evaluated on a 5-point Likert scale. Over 90% of text paged consult requests included contact information and reason for consult; 14% indicated level of urgency. In ordinal logistic regression, reason for consult was most strongly associated with quality (OR 22.4; 95% CI 8.1 to 61.7), followed by callback number (OR 6.2; 95% CI 0.8 to 49.5), caller's name (OR 5.0; 95% CI 1.9 to 13.1) and level of urgency (OR 3.3; 95% CI 1.6 to 6.7). Results suggest that text paged consult requests often include most informational elements, and that urgency, often missing, may not be as 'essential' for text pages as it was once thought to be.

Introducción. Actualmente el timbre conecta a los pacientes con la expectativa de una asistencia inmediata cuando perciben una necesidad, ya sea para asistencia de rutina o tengan un cambio agudo en su condición. El tiempo de atención al timbre impacta en la calidad de atención, satisfacción del paciente, y el flujo de trabajo. El objetivo fue describir el tiempo promedio de la respuesta al timbre en la Unidad Coronaria. Metodología. Estudio transversal del tiempo de respuesta al timbre estratificado por turno. Se recogieron datos sociodemográficos de los pacientes, los motivos de la llamada al timbre, y la satisfacción de los pacientes de forma anónima y digital. Resultados. Se analizaron 200 timbres, con un tiempo promedio de 5’42”. El promedio de edad de los pacientes que accionaron el timbre fue de 56 años, de los cuales 51% eran mujeres. Los principales motivos de llamada fueron la movilización (24.9%) e higiene/eliminación (19.2%), y los pacientes se mostraron satisfechos siempre o casi siempre (81%) con el tiempo de atención al timbre. No se halló una asociación entre los días de internación y la cantidad de llamadas al timbre. Discusión. A pesar de que el tiempo es superior a los “minutos dorados”, los pacientes presentan un elevado grado de satisfacción. La variabilidad de los tiempos en los distintos turnos y los principales motivos de llamada por turno muestran un enorme desafío en la gestión de enfermería para anticipar y priorizar las necesidades que el paciente transmite a través del timbre. Abstract Introduction. Currently, the call light connects patients with the expectation of immediate assistance when they perceive a need, whether it is for routine assistance or a sudden change in their condition. The response time to the call bell impacts the quality of care, patient satisfaction, and workflow. The objective of this study was to describe the average response time to the call bell in the Coronary Unit. Methodology. A cross-sectional study of response time to the call bell stratified by shift, over 3 days, with a minimum of 7 days between each day. Sociodemographic data of patients, reasons for the call bell, and patient satisfaction were collected anonymously and digitally. Results. 200 call bells were analyzed, with an average response time of 5'42". The average age was 56 years, with 51% being female. The main reasons for calling were mobilization (24.9%) and hygiene/elimination (19.2%). Most patients were satisfied with the response time to the call bell (81% always or almost always). There was no association found between length of stay and the number of call bells. Discussion. Despite the response time being longer than the "golden minutes," patients show a high degree of satisfaction. The variability of response times in different shifts and the main reasons for calling by shift show a huge challenge in nursing management to anticipate and prioritize the needs that the patient expresses through the call bell.

Background: Secure text messaging systems (STMS) offer HIPAA-compliant text messaging and mobile phone call functionalities that are more efficient than traditional paging. Although some studies associate improved provider satisfaction and healthcare delivery with STMS use, healthcare organizations continue to struggle with achieving widespread and sustained STMS adoption. Objective: To understand the barriers to adoption of an STMS among physicians and advanced practice providers (APPs). Design: We qualitatively analyzed free-text comments that clinicians (physicians and APPs) across a large healthcare organization offered on a survey about STMS perceptions. Participants: A total of 1110 clinicians who provided a free-text comment in response to one of four open-ended survey questions. Approach: Data were analyzed using a grounded theory approach and constant comparative method to characterize responses and identify themes. Key Results: The overall survey response rate was 20.5% (n = 1254). Clinicians familiar with the STMS frequently believed the STMS was unnecessary (existing tools worked well enough) and would overburden them with more communications. They were frustrated that the STMS app had to be downloaded onto their personal mobile device and that it drained their battery. Ambiguity regarding who was reachable in the app led to missed messages and drove distrust of the STMS. Clinicians saw the exclusion of other care team members (e.g., nurses) from the STMS as problematic; however, some clinicians at hospitals with expanded STMS access complained of excessive messages. Secondhand reports of several of these barriers prevented new users from downloading the app and contributed to ongoing low use. Conclusions: Clinicians are reluctant to adopt an STMS that does not offer a clear and trustworthy communication benefit to offset its potential burden and intrusiveness. Our findings can be incorporated into STMS implementation strategies that maximize active users by targeting and mitigating barriers to adoption. [ABSTRACT FROM AUTHOR]

We conceptualize infection prevention and control (IPAC) as a form of risk communication in the hospital and examine how doctors and nurses interpret and adopt IPAC measures in the wards. We conducted a 20-week ethnography in a Canadian hospital in which we observed doctors' and nurses' routines, infection prevention practices, and barriers they encountered when following IPAC guidelines. After the observation period, we conducted interviews with doctors and nurses to gauge their perceptions of risk and how they make IPAC decisions while working in the wards. Doctors and nurses perceive the hospital as a site of risk, and expressed this anxiety in disinfection routines and cleansing rituals. This risk prevention behaviour is mediated by situational and lived experience, and not expressed consistently. Doctors and nurses negotiate IPAC protocols with individual perceptions of risk, material limitations, and more pressing needs. IPAC behaviour could be reinforced by improving risk communication in the hospital, first, by involving workers as stakeholders in managing the risk of infection, and second, by acknowledging various forms of risk knowledge, including embodied and situated experience, as well as material constraints. We recommend developing participatory models of risk communication that engage stakeholders in long-term dialogue, considering their risk perceptions, risk tolerance, and challenges to comply with guidelines; communicating IPAC measures as a way to protect patients and emphasizing personal risk for hospital workers; and conducting regular in-person training sessions to ensure that any concerns can be voiced. [ABSTRACT FROM AUTHOR]

COVID-19 has caused a transformation in the organizational structure of the healthcare system that directly affects the management of its communication. This article aims to know the communication strategy of hospitals in Spain in a context of normality and what have been the main changes and adaptation needs caused by the pandemic. For this purpose, the information is collected and analyzed from a structured questionnaire and two focus group with health communication professionals. The results obtained confirm that pandemic modifies the type of tasks carried out in the three communication areas and transforms both the information requested and the priority in the use of channels for its transmission. Furthermore the work concludes that the health crisis has accelerated the development of the digitization and of Spanish health and communication systems. Finally, the professionals consider that the pandemic has favored the knowledge and recognition of the communication function inside and outside the hospital. [ABSTRACT FROM AUTHOR]

Healthcare staff are typically exposed to hundreds of alarms each shift; researchers believe that the number of alarms may be more than 1000 alarms per shift. This may lead to staff becoming desensitised to the alarm, leading to a delayed or inadequate response to the alarm, known as alarm fatigue. Clinical-grade wireless smartphones are now carried by clinical staff to receive calls and notifications from a nurse call system.

ABSTRACT Objectives: to validate and apply a change-of-shift instrument using the SBAR (Situation-Background-Assessment-Recommendation) tool. Methods: methodological study for the validation of an instrument. It was validated by ten judges from the area of nursing teaching and care and applied in a surgical gastroenterology ward by 11 nursing technicians in February 2019. The analyses considered descriptive statistics. Results: the judges analyzed the instrument with a content validity index of 91.7% and made suggestions, which led to the second version of the instrument. The participants reported that the predominant modality of shift handover is oral, in the nursing room, lasting six to ten minutes. Most pay attention during shift change, mention that delays and early departures interfere in the activity and believe that the instrument provides the necessary information and is viable. Conclusions: the instrument built was validated, and its application proved relevant, as it was considered necessary and feasible.

Background: Implementation of the Situation–Background–Assessment–Recommendation (SBAR) communication technique has been shown to increase nurse–physician communication and collaboration. However, data regarding its implementation in ophthalmology settings are limited. Objective: The purpose of this study was to evaluate the impact of implementing SBAR on nurse–physician communication and on the safety and satisfaction of patients undergoing cataract surgery. Materials and Methods: This cross-sectional study was conducted in the Ophthalmology Department of Zhongshan Hospital, Xiamen University, Xiamen, China, from April 2016 to December 2018. SBAR was implemented through a 1-h course that was repeated every 2 months for 2 years. All nurses and physicians completed the Physician–Nurse Communication Satisfaction Questionnaire before SBAR implementation and 1- and 2-year post-implementation. In addition, all patients who underwent cataract surgery during the defined pre-implementation and 1- and 2-year post-implementation periods were invited to complete a patient satisfaction questionnaire. Results: In total, 10 nurses and 6 physicians completed all three pre- and post-implementation surveys. In addition, 1215 patients undergoing cataract surgery participated: 358 in the pre-implementation phase, 425 in the 1-year post-implementation, and 432 in the 2-year post-implementation. Physician–nurse communication significantly improved in both 1- and 2-year post-implementation periods compared with the pre-implementation phase (P < 0.01). In addition, there was a significant increase in patient satisfaction scores (P < 0.01) and a decrease in medical complaints and malpractices (P < 0.01) between the pre- and post-implementation phases. Conclusion: SBAR is a useful tool for enhancing nurse–physician communication and for improving the safety and satisfaction of patients undergoing cataract surgery. [ABSTRACT FROM AUTHOR]

Willingness to Respond (WTR) is the measurement of employees' preferences to come to work during off-hours when needed. Are these answers given before a disaster realistic? Another question of the study was, "Can we speed up the required staff to reach the hospital?" WTR survey has applied to emergency service staff. After that, the off-duty staff was called to work at a time they did not know beforehand. The study tried to identify how much WTR reflected the reality. Ninety of 98 (91.8%) participants whose surveys were evaluated answered "Yes" to "If you are called in case of disaster, would you come to duty?" question. When asked whether they will come to work according to disaster types, this rate was measured as 36.7% in "In the case of an infectious disease of which treatment is not clear". WTR surveys can be used to predict the level of participation of staff on off-hours in meeting the need for additional labor. These surveys' results can be expected to be similar to the labor participation rates in case of a real disaster and the arrival time of the staff at the hospital can be improved with new communication methods. [ABSTRACT FROM AUTHOR]

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We examine how physicians and nurses use available communication technologies and identify the implications for communication and patient care based on the theory of workarounds.Materials and Methods: We conducted a qualitative study at 4 U.S. hospitals during 2017. Researchers spent 2 weeks at each hospital conducting unit-based observation, shadowing, interviews, and focus groups with nurses and physicians. Using an iterative process, we inductively coded and thematically analyzed data to derive preliminary themes. The theory of workarounds provides an organizational lens on workarounds, consisting of 5 components: antecedents, types, effects, managerial stance, and organizational challenges of workarounds. The first 3 components of the theory helped us to organize and explain our findings.Results: Communication technologies consisted of pagers and telephones. Antecedents to workarounds included one-way information flow, differential access related to differences in technology types, and technology mismatch. Types of workarounds included bypassing a variety of obstacles and substituting for unavailable resources. Direct effects of workarounds included pager fatigue, interruptions in patient care, and potential errors.Discussion: One-way communication technologies created an environment where workarounds could flourish. By placing results within the context of the theory of workarounds, we extend what we know about why and how workarounds develop, and offer strategies to minimize workarounds' adverse effects.Conclusions: Through the theory of workarounds, we see that there is a trajectory to workarounds with potential consequences for clinicians and patients. Two-way communication technologies could minimize workarounds and gaps in information exchange, and reduce unnecessary interruptions and the potential for adverse events. [ABSTRACT FROM AUTHOR]

Integration of smartphone technology with the patient call-bell system provides the opportunity to enhance patient safety by supporting nurses' ability to communicate and prioritize care delivery directly. However, challenges are associated with achieving a balance between alarm support and alarm fatigue, including distracting nurses from patient care or desensitizing the nurse to other alarms and calls [1]. Our hospitals have quantitative and anecdotal reports of seriously high volumes of wireless alerts on the nurses' smartphones. Nurses have complained that the phones are generating too much noise to consume or timely prioritize. Preliminary alarm inventory revealed the Bed Exit wireless alert as a leading contributor of signal volume across many units and hospitals. The lack of standard policies and workflow improvement processes has increased nuisance alarms, making these Health Information Technologies less useful and safe. Using system data, workflow observations, and nursing interviews, Singh and Sittig's HIT Safety framework [2] was applied to identify and prioritize sociotechnical factors and interventions that impact the end-to-end Bed Exit alarm workflow. This study reviews the application of sociotechnical models and frameworks to reduce wireless calls without introducing risk and impacting patient care.

Despite the potential of health information technology (HIT) systems to significantly reduce medical errors, streamline clinical processes, contain healthcare costs, and ultimately improve the quality of healthcare, their adoption by hospitals in the United States has been rather slow. To study this adoption process and get insights into the underlying mechanisms, in this work we synthesize the theories on social networks and knowledge transfer. We propose a research framework in which the absorptive capacity of a potential adopter and the collective disseminative capacity of connected adopters act as two key determinants of knowledge transfer in a socioeconomic network, and these two capacities substitute for each other in affecting HIT adoption. We also propose that, in a network setting, the mechanism of knowledge transfer manifests quite differently from that of social contagion in its impact on the diffusion process at different stages of adoption. Using a large longitudinal data set covering adoption decisions of more than five thousand hospitals across a thirteen-year horizon, we find strong support for our hypotheses. Our analysis shows that knowledge flow in provider networks plays a key role in fostering technology diffusion in initial years, allowing the contagion effect to set in sooner for quicker adoption in later years. Therefore, recent efforts at multiple levels to form integrated healthcare delivery networks should accelerate HIT adoption. [ABSTRACT FROM PUBLISHER]

Background: Rationale: Internal communication within an organization ensures that workers carry out their activities effectively; which, in the health context, translates into prioritizing the patients´ well-being and quality of life. Objective: to determine the relationship between internal communication and job performance in Peruvian health professionals during the COVID-19 pandemic. Methods: descriptive correlational study, carried out with the participation of 100 professionals from the maternal-infant department of a public hospital in Chimbote, Peru. Two data collection instruments were applied using online Google questionnaires, corresponding to the variables internal communication and job performance. The information was recorded and processed through descriptive statistics, through frequencies and percentages. The Statistical Package for the Social Sciences program version 26 was used, and a reliability of 95% was considered for Pearson's bivariate correlation. Results: the work performance of the maternal and child department professionals showed a high level (51%), and that of internal communication was medium (57%). In the analysis by dimensions, a direct and significant relationship was found between descending and job performance, as well as between responsibility and internal communication. Conclusion: the level of internal communication was medium, adequate with respect to the COVID-19 pandemic situation, and was directly and significantly related to job performance in the Peruvian health professionals who participated in the study. [ABSTRACT FROM AUTHOR]

Abstract: Effective communication is essential for quality patient care, and paging remains among the most common forms of communication despite the introduction of secure texting platforms. The goal of this project was to use quantitative and qualitative analyses of paging to guide improvements in paging best practices. A retrospective analysis of pages sent over a 7-day period was completed, characterizing the volume, content, and effectiveness of pages both preintervention and 3-month postintervention. The content of each page was categorized into laboratories, medications, vital signs, diet, patient assessment/clinical change, pain, or miscellaneous/other. Effectiveness was based on the following five critical elements: (1) two patient identifiers, (2) the sender's name, (3) the sender's callback number, (4) priority or acuity of the page, and (5) patient-care concern. Pages were considered successful if they contained all the five essential elements. The preintervention results guided interventions. Of 3,483 included pages, 1,806 and 1,677 were sent during the preintervention and postintervention periods, respectively. Adherence to all essential paging elements increased from 15.2% to 40% ( p < .001). The largest deficiency was labeling the urgency of a page, which increased from 31.6% to 51.9% ( p < .001). Quantitative and qualitative analyses of pages effectively guided this project to increase the standardization of paging., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 National Association for Healthcare Quality.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background To explore the current situation, existing problems and possible causes of said problems with regards to physician-nurse communication under an environment of increasingly widespread usage of Hospital Information Systems and to seek out new potential strategies in information technology to improve physician-nurse communication. Methods Semi-structured interviews were conducted with 20 physicians and nurses in five leading tertiary grade A hospitals in Beijing, China (two physicians and two nurses in each hospital). The interviews primarily included three aspects comprising the current situation and problems of clinical physician-nurse communication, the application and problems of Hospital Information Systems, and assessments on the improvement of physician-nurse communication through the usage of information technology. The inductive conventional content analysis approach was employed. Results (1) Physicians and nurses are generally quite satisfied with the current situation of communication. However, the information needs of nurses are prone to being overlooked, and the communication methods are primarily synchronous communication such as face-to-face and phone communication. (2) Hospital Information Systems are gradually being used for physician-nurse communication; in the meantime, physicians and nurses face challenges with regards to the improvement of physician-nurse communication through the usage of information technology. Challenges differ based on the different stages of using the system and the different levels of understanding of physicians and nurses towards information technology. Their dissatisfaction mainly deals with system errors and the level of convenience in using the system. (3) In-depth interviews found that in general, physicians and nurses have a strong interest and trust in improving physician-nurse communication through appropriate information technology, e.g., communication methods such as information reminders for physicians and nurses through mobile devices and instant voice-to-text conversion methods. Conclusions There are objective risks in physician-nurse communication in Chinese hospitals, and clinical information systems lack solutions to the relevant problems. Developing a dedicated, mobile, quick and convenient module for physician-nurse communication within existing hospital information system with automatic reminders for important information that segregates between synchronous and asynchronous communication according to the different types of information could help improve physician-nurse communication.

ObjectivesServices based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals.MethodsApplication of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases.ResultsDuring the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively.ConclusionsFrom an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital.

Resumo OBJETIVO Descrever a implantação de um fluxograma de transferência do cuidado de pacientes em pós-operatório, a partir de um modelo de classificação de risco. MÉTODO Relato de experiência sobre a implantação de projeto piloto entre sala de recuperação pós-anestésica e unidade de internação cirúrgica, desenvolvido entre dezembro/2016 e março/2017, visando a transferências do cuidado de pacientes com baixo risco de mortalidade pós-operatória, em um hospital universitário do Sul do Brasil. RESULTADOS O projeto possibilitou agilizar a alta do paciente da Sala de Recuperação Pós-Anestésica para a unidade de internação cirúrgica, qualificar os registros quanto aos cuidados de enfermagem e otimizar o tempo dos enfermeiros, em ambas unidades, para as atividades assistenciais. CONCLUSÃO A implementação de um fluxograma de transferência do cuidado a partir da classificação de risco para pacientes em pós-operatório contribuiu para uma comunicação mais efetiva, culminando em melhorias na segurança do paciente.

Objective: to describe the construction of a shift change instrument using the SBAR (Situation-Background-Assessment-Recommendation) methodology. Methodolgy: this is a methodological study for the construction of an instrument of a shift change in a surgical gastroenterology ward. A comprehensive bibliographic review was done on the SBAR methodology. The Research Ethics Committee of the scenario research institution approved the study. Results: the items included in the instrument were: patient identification data that included: date, bed, name, age, sex, date of admission; indicators: patient classification system, presence of companion; Situation (S): medical diagnosis and nursing diagnoses; Background (B): allergies, comorbidities, surgical history, isolation / precautions and barriers to communication; Assessment (A): vital signs, nutritional aspects, eliminations, dressings, drains, catheters and medications; Recommendation (R): interconsultations, nursing interventions and intercurrences. Conclusion: The instrument contributes to the standardization of nurses' change of shift. [ABSTRACT FROM AUTHOR]

Quality Problem or Issue: Night-shift medical providers frequently experience limited sleep resulting in fatigue, often because of paging activity. Streamlined medical-specific communication interventions are known to improve sleep and communication among these providers.Initial Assessment: We found that non-urgent paging communication occurred frequently during night-shifts, leading to provider sleep disturbances within our institution. We tested a quality improvement (QI) intervention to improve paging practices and determined its effect on provider sleep.Choice Of Solution: We used a Plan-Do-Study-Act QI model aimed at improving clinician sleep and paging communications.Implementation: We initially conducted focus groups of nurses and physician trainees to inform the creation of a standardized paging intervention. We collected actigraphy and sleep log data from physicians, nurse practitioners, and physician trainees and performed electronic collection of paging frequency data.Evaluation: Data were collected between December 2015 and March 2017 from pediatric residents, pediatric hematology/oncology (PHO) fellows, hospitalist medicine nocturnists and nurses working during night-shift hours in PHO inpatient units. We collected baseline data before implementation of the QI intervention and at 1 month post-implementation. Although objective measures and provider reports demonstrated improved medical-specific communication paging practices, provider sleep was not affected.Lessons Learned: Provider-based standardization of paging communication was associated with improved medical-specific communication between nurses and providers; however, provider sleep was not affected. The strategies used in this intervention may be transferable to other clinics and institutions to streamline medical-specific communication. [ABSTRACT FROM AUTHOR]

Inadequate communication is a factor in suboptimal junior doctor management of deteriorating ward patients. Junior doctors’ information and communication technology (ICT) systems are not the sole cause or cure for this. However, junior doctors are already dissatisfied with existing technologies for general hospital communication. The Deterioration Communication Management Theory (DCMT) provides a means to approach these issues by uniting two themes: 1) factors affecting the properties of ICT used to communicate to junior doctors; and 2) factors affecting junior doctor interpretation of communication about deteriorating hospital patients. ICT factors include how the combination of physical devices and mode of usage affect user perception of system reliability and efficiency. Junior doctors interpret clinician communication about patient deterioration in terms of risk, which is affected by their contextual responsibility and experience. Perceived risk and contextual experience in turn affects their communication efficiency. Combining these themes gives more options to explain junior doctor communication in this clinical context and to design ICT systems to improve it. [ABSTRACT FROM AUTHOR]

The participation-based design of a social media strategy for health organizations, and the evaluation of the experience in the Reina Sofía University Hospital are presented. The methodology of collaborative and multidisciplinary design was developed in five phases: identification of target actors; consensus on objectives, channels and content lines; results analysis and feedback; (pre)campaign design; collaborative elaboration of social media strategy. The evaluation included social media monitoring (quantitative evaluation of external communication) and content analysis of semi-structured interviews with hospital managers (qualitative evaluation of internal communication). Results show the positive impact on the external communication and the participants' satisfaction with the co-design, revealing that participatory and interdisciplinary approach, managerial support and professionalization represent the main aspects of social media presence for health organizations. [ABSTRACT FROM AUTHOR]

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The article offers information on hospital information management systems in the hospitals of Kenya. Topics discussed include increasing use of information technology in patient care, increasing documentation, and coding and billing; role of Information systems (IS) in managing healthcare costs and in improving the quality of care; and new developments in technology, including the use of the internet and other modes of communication to develop health information systems of hospitals.

Objectives: Handovers are associated with medical errors, and our primary objective is to identify missed diagnosis and goals immediately after a shift handover. Our secondary objective is to assess clinicians' diagnostic accuracy in anticipating clinical events during the night shift.Design: Single-center prospective observational cohort study.Setting: Thirty-bed tertiary ICU in Sao Paulo, Brazil.Patients: Three-hundred fifty-two patient encounters over 44 day-to-night handovers.Interventions: None.Measurements and Main Results: We used a multimethods approach to measure transmission of information among staff physicians on diagnoses and goals for the night shift. We surveyed clinicians immediately after a handover and identified clinical events through chart abstractions and interviews with clinicians the next morning. Nighttime clinicians correctly identified 454 of 857 diagnoses (53%; 95% CI 50-56) and 123 of 304 goals (40%; 95% CI, 35-46). Daytime clinicians were more sensitive (65% vs 46%; p < 0.01) but less specific (82% vs 91%; p < 0.01) than nighttime clinicians in anticipating clinical events at night, resulting in similar accuracy (area under the receiver operating characteristic curve, 0.74 [95% CI, 0.68-0.79] vs 0.68 [95% CI 0.63-0.74]; p = 0.09). The positive predictive value of both daytime and nighttime clinicians was low (13% vs 17%; p = 0.2). Gaps in diagnosis and anticipation of events were more pronounced in neurologic diagnoses.Conclusions: Among staff intensivists, diagnoses and goals of treatment are either not conveyed or retained 50-60% of the cases immediately after a handover. Clinicians have limited ability to anticipate events, and the expectation that anticipatory guidance can inform handovers needs to be balanced against information overload. Handovers among staff intensivists showed more gaps in the identification of diagnostic uncertainty and for neurologic diagnoses, which could benefit from communication strategies such as cognitive checklists, prioritizing discussion of neurologic patients, and brief combined clinical examination at handover. [ABSTRACT FROM AUTHOR]

With the continuous optimization and reform of the healthcare system, many of the equipment in hospitals are developing in the direction of intelligence. At present, the hospital bed call system relies mainly on the traditional cable. Wired call system wiring is tedious and high in cost. It can sometimes cause short circuits, circuit breakages, and other problems, which will affect the timely treatment of patients. Based on ZigBee CC2530 software and hardware technology, this paper designs a wearable wireless calling system in hospitals based on ZigBee. ZigBee technology is a short distance wireless communication technology, which is characterized by low power consumption and low cost. This article sets up the style of the watch based on the ZigBee wireless communication hardware. The nurse can detect the patient's location at all times through the wireless call system device worn by the patient. When a patient is away from his or her hospital bed and suddenly needs care, the patient can call the nursing station according to the wireless communication system worn on his wrist. The nurse can arrive quickly and carry out the treatment, which can greatly alleviate any emergencies. The application of this wireless call system has significantly improved the level of hospital care and further promoted the development of hospital equipment in the direction of intelligence. [ABSTRACT FROM AUTHOR]

Ziel der Pilotstudie war es, bei Beschäftigten in psychiatrischen Kliniken mittels leitfadengestützter Interviews zu ermitteln, welche Anteile der Arbeitszeit theoretisch für Fort- und Weiterbildung, organisatorische und Dokumentationspflichten sowie gesetzlich verpflichtende Belehrungen zu veranschlagen sind. Es wurden 47 Ärzte, 39 Pflegekräfte, 34 Psychologen und 35 Sozialarbeiter aus acht Versorgungskliniken interviewt. Die Ergebnisse zeigen, dass der theoretisch verbleibende Zeitanteil für direkten Patientenkontakt gering ist. Besonders ungünstig stellt sich die Situation bei Oberärzten, pflegerischen Stationsleitungen und Teilzeitkräften dar. Alle ermittelten patientenfernen Tätigkeiten waren jedoch ebenfalls unverzichtbare Qualitätsmerkmale. Beschäftigte in deutschen psychiatrischen Kliniken müssen deshalb regelmäßig Präferenzentscheidungen treffen, welche Aufgaben sie vernachlässigen, zu denen sie eigentlich verpflichtet sind. [ABSTRACT FROM AUTHOR]

Background Effective communication between health professionals contributes to safe and efficient patient care, whereas communication breakdown can lead to adverse patient outcomes and increased healthcare expenditure. Information on how pharmacists and doctors communicate with each other in hospitals is limited. Objective To explore usage and perceptions of communication methods by doctors and pharmacists in hospital settings. Setting Four public hospitals in Australia. Method A mixed method study utilising a pilot questionnaire, semi-structured interviews, and electronic survey was designed. Frequentist statistics and logistic regression were used to analyse survey data. Thematic analysis was conducted to evaluate semi-structured interview data and free-text survey comments.Main Outcome Measures: Frequency of use of communication methods, perceptions of the convenience, time taken to use, accuracy and effectiveness of each method. Results More than 95% of doctors and pharmacists combined used face-to-face and phone calls to communicate with each other, 70% used a medication management plan, and 62% used progress notes. A preference for oral communication was confirmed with the expressed need for building professional rapport and receiving responses. Perceptions regarding effectiveness of oral communication methods were related to perceptions of their convenience and accuracy. Professional groups described differences in perceived ownership of various modes of communication. Conclusions Preferences for oral communication create potential issues with recall and comprehension. Integrating oral communication features into written communication methods, e.g. creating responses, conversations, building rapport, may change doctors' and pharmacists' perceptions of effectiveness. Communication receipt and response functionality in electronic medication and record management systems may improve communication. [ABSTRACT FROM AUTHOR]

Background: Good communication between physicians and nurses is important for the understanding of disease status and treatment feedback; however, certain issues in Chinese hospitals could lead to suboptimal physician-nurse communication in clinical work.Methods: Convenience sampling was used to recruit participants. Questionnaires were sent to clinical physicians in three top tertiary Grade-A teaching hospitals in China and six hundred and seventeen physicians participated in the survey.Results: (1) Common physician-nurse interactions were shift-change reports and provisional reports when needed, and interactions expected by physicians included face-to-face reports and communication via a phone or mobile device. (2) Most respondents believed that the need for information in physician-nurse interactions was high, information was moderately accurate and timely, and feedback regarding interaction time and satisfaction indicated that they were only average and required improvement. (3) Information needs in physician-nurse interactions differed significantly according to hospital category, role, workplace, and educational background (p < .05).Conclusions: There was a considerable need for information within physician-nurse interactions, and the level of satisfaction with the information obtained was average; requirements for the improvement of communication differed between physicians and nurses because of differences in their characteristics. Currently, the use of information technology in physician-nurse communication was less common but was highly expected by physicians. [ABSTRACT FROM AUTHOR]

VerbalCare is a mobile software platform for hospital patients and nursing staff to communicate in real-time. The purposes of this study were to (1) identify and evaluate icons for the VerbalCare tablet application and (2) examine use and satisfaction with this tablet application in a paediatric post-acute hospital. Hospital nursing staff were surveyed to identify the most common reasons children use the “nursing call bell”. Icons for the VerbalCare tablet application were developed to match the identified call bell requests and be understood by children. Through structured interview, three children provided feedback on the icons. Following staff training, the system was implemented for five patients (8–18 years). Data on frequency of use, types and timing of requests were collected via the internal software. Satisfaction surveys were completed at discharge. The VerbalCare application was used most frequently to communicate the need to use the bathroom (24%) and the need to get something (21%). Request frequency was consistent across morning, afternoon and evening and the tablet was used 40% of available days. These results indicate that children in a paediatric post-acute care hospital were able to use a tablet application for communicating with their nurse and reported satisfaction with the experience.Implications for RehabilitationThe VerbalCare tablet application was developed to allow patients to convey specific messages to nursing staff who are not in the patient’s room.Children of varying ages were able to use the VerbalCare tablet application to communicate varying messages to hospital nursing staff and were satisfied with its use. [ABSTRACT FROM PUBLISHER]

A community orientation strategy may be a socially responsible way for hospitals to simultaneously improve financial performance and community health, in accordance with the Affordable Care Act. Using data from the AHA Annual Survey, AHRF, and CMS Cost Reports, this study examined the association between hospital community orientation and three measures of financial performance, and whether that relationship differs for some types of hospitals. The analysis revealed that hospital community orientation was positively associated with total margin and that not-for-profit hospitals engaging in higher levels of community orientation experienced lower operating margins, on average, relative to for-profit hospitals. [ABSTRACT FROM AUTHOR]

In this paper, a brief review on the emergency department overcrowding problem and its associated solution methodologies is presented. In addition, a case study of an urgent care center is investigated that demonstrates different simulation-based solution strategies to deal with the Emergency Department overcrowding problem. More precisely, a simulation study is conducted to identify critical aspects and propose possible scenarios to configure an urgent care center. Based on statistical data supported from an international competition for simulation, several discrete-event simulation models have been built to study the behavior of a planned system and identify the required resources such as number of procedure and examination rooms, number of doctors, assistants and nurses. Each model contains a specific simulation scenario. The solution scenario has been developed based on combining key elements of the different previously developed scenarios. These elements have been observed carefully through a verification process combined with a heuristic optimization approach to identify their impact on the performance of the system. In particular, different patient arrival patterns with specific proportional critical level have been investigated. In addition, two main responses have been observed namely, the Leave Without Being Seen (LWBS) percentage and staffing and operational costs. [ABSTRACT FROM AUTHOR]

AIM: The aim of this exploratory study was to determine whether the level of nursing teamwork is correlated to call light answering time in acute care hospital patient care units. Background: Teamwork has been shown to improve productivity. In this study, we examine the relationship between unit call light response time as a measure of productivity and the level of teamwork on the unit. METHOD: The Nursing Teamwork Survey was administered to nursing staff on 18 inpatient units in 3 hospitals. In addition to the overall teamwork score, the NTS has 5 subscales. Call light response times were collected from electronic systems which measures the time it takes for nursing staff on a given unit to respond to patient call lights. RESULTS: There was no significant relationship between call light response time and teamwork overall or on the five subscales. Shared mental models, which comprise the conceptual understanding of the roles and responsibilities of each team member, however was moderately correlated with call-light answering times. CONCLUSIONS: It is logical that shared mental models would be associated with call light response time since a common problem in patient units is the "it's not my job syndrome" where nursing staff do not answer call lights for patients assigned to someone else. More research with a larger number of patient units is needed to validate these findings.OBJETIVO: La finalidad de estudio exploratorio fue determinar si el nivel de trabajo en equipo de enfermería tiene correlación con el tiempo de espera de atención al timbre del paciente en unidades de internación hospitalaria para cuidados intensivos. Antecedentes: Se ha demostrado que el trabajo en equipo mejora la productividad. El presente estudio investigó la relación entre tiempo de respuesta de la unidad a la atención del llamado del paciente como medida de productividad y del nivel de trabajo en equipo en la unidad. MÉTODO: El instrumento Trabajo en Equipo de Enfermería fue utilizado con el personal de enfermería de tres hospitales. Además de la puntuación total, el instrumento cuenta con 5 sub-escalas. El tiempo de respuesta al timbre del paciente fue registrado en los sistemas informáticos que miden el tiempo necesario para que el personal de enfermería de una determinada unidad atienda a la llamada del timbre del paciente. RESULTADOS: No hubo relación significativa entre el tiempo de respuesta al timbre y el puntaje global del trabajo en equipo o los puntajes de las cinco sub-escalas. Mientras tanto, modelos mentales compartidos, que comprenden el entendimiento conceptual de los papeles y responsabilidades de cada miembro del equipo, fueron moderadamente correlacionados con el tiempo de respuesta al llamado del timbre. CONCLUSIONES: Es lógico que los modelos mentales compartidos estén asociados al tiempo de respuesta al llamado, ya que un problema común en unidades de internación es el "síndrome de ese no es mi trabajo", en el cual el personal de enfermería no responde al timbre de los pacientes que no tienen asignados. Se necesita de más investigaciones en un número mayor de unidades de internación de pacientes para validar estos resultados.OBJETIVO: o objetivo deste estudo exploratório foi determinar se o nível de trabalho em equipe de enfermagem está correlacionado ao tempo de resposta às chamadas de pacientes, em unidades de hospitais de tratamento intensivo. Antecedentes: tem sido reportado que o trabalho em equipe melhora a produtividade. A relação entre o tempo de resposta às chamadas de enfermagem foi examinada neste estudo como uma medida da produtividade e do nível de trabalho em equipe, na unidade. MÉTODO: o Nursing Teamwork Survey foi administrado nas equipes de enfermagem de 18 unidades de internação, em três hospitais. Além da pontuação global do trabalho em equipe, o instrumento tem cinco subescalas. O tempo de resposta às chamadas de enfermagem foi coletado nos sistemas de chamadas de enfermagem que registram o tempo que a equipe de enfermagem, em uma determinada unidade, leva para atender as chamadas dos pacientes. RESULTADOS: a relação entre o tempo de resposta às chamadas de enfermagem e a pontuação global do trabalho em equipe ou as pontuações das cinco subescalas não foi significante. Entretanto, os modelos mentais compartilhados, que compreendem o entendimento conceitual dos papéis e responsabilidades de cada membro da equipe, foram moderadamente correlacionados ao tempo de resposta às chamadas da campainha. CONCLUSÕES: parece lógico que os modelos mentais compartilhados estariam associados ao tempo de resposta às chamadas já que um problema comum em unidades hospitalares está relacionado à "síndrome: este não é meu trabalho", ou seja, o pessoal de enfermagem não responde às chamadas de pacientes que não estão sob sua responsabilidade. Mais estudos com número maior de unidades hospitalares são necessários para validar estes resultados.