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World Journal of Surgery

, Volume 34, Issue 11, pp 2524–2529 | Cite as

Resident Workload, Pager Communications, and Quality of Care

  • Shaun P. Patel
  • Jay S. Lee
  • David N. Ranney
  • Shaza N. Al-Holou
  • Christopher M. Frost
  • Meredith E. Harris
  • Sarah A. Lewin
  • Erqi Liu
  • Arin Madenci
  • Allen A. Majkrzak
  • Jessica Nelson
  • Sarah F. Peterson
  • Kerri A. Serecky
  • David A. Wilkinson
  • Brandon M. Wojcik
  • Michael J. EnglesbeEmail author
  • Raymond J. Lynch
Article

Abstract

With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their workload and help identify inefficiencies in hospital communication. We hypothesized that above a certain workload threshold, paging data would suggest breakdowns in communication and implications for quality of care. All pages sent to six general surgery interns at the University of Michigan over the course of one academic year (7/1/2008–6/30/2009) were retrospectively categorized by sender type, message type, message modifier, and message quality. Census, discharge, and admission information for each intern service were also collected, and intern duties were further analyzed with respect to schedule. “On-call” days were defined as days on which the intern bore responsibility for care of all admitted floor patients. The interns received a total of 9,843 pages during the study period. During on-call shifts, each intern was paged an average of 57 ± 3 times, and those on non-call shifts received an average of 12 ± 3 pages. Floor/intensive care unit (ICU) nurses represented 32% of the page volume received by interns. Interestingly, as patient volume increased, there was a decrease in the number of pages received per patient. By contrast, at higher patient volumes, there was a trend toward an increasing percentage of urgent pages per patient. At high intern workloads, our data suggest no major communication breakdowns but reveal the potential for inferior quality of care.

Keywords

Peripherally Insert Central Catheter Paging Data Message Modifier Large Academic Medical Center Pager Message 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Pascoe JM (1989) Sleep deprivation and performance of residents: the power of the study. JAMA 262:775CrossRefPubMedGoogle Scholar
  2. 2.
    Rosen IM, Shea JA, Bellini LM (2003) Residents’ work hours. N Engl J Med 348:664–666CrossRefPubMedGoogle Scholar
  3. 3.
    Sloan VS (1999) Reducing sleepiness on the roads and on the wards. JAMA 281:134–135CrossRefPubMedGoogle Scholar
  4. 4.
    Veasey S, Rosen R, Barzansky B et al (2002) Sleep loss and fatigue in residency training: a reappraisal. JAMA 288:1116–1124CrossRefPubMedGoogle Scholar
  5. 5.
    Quan SF (2009) Work hours during residency training—the IOM speaketh. J Clin Sleep Med 5:9–10PubMedGoogle Scholar
  6. 6.
    Blum NJ, Lieu TA (1992) Interrupted care. The effects of paging on pediatric resident activities. Am J Dis Child 146:806–808PubMedGoogle Scholar
  7. 7.
    Harvey R, Jarrett PG, Peltekian KM (1994) Patterns of paging medical interns during night calls at two teaching hospitals. Can Med Assoc J 151:307–311Google Scholar
  8. 8.
    Katz MH, Schroeder SA (1988) The sounds of the hospital. Paging patterns in three teaching hospitals. N Engl J Med 319:1585–1589CrossRefPubMedGoogle Scholar
  9. 9.
    Sebat F, Musthafa AA, Johnson D et al (2007) Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Crit Care Med 35:2568–2575CrossRefPubMedGoogle Scholar
  10. 10.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMedGoogle Scholar
  11. 11.
    Chiu T, Old A, Naden G et al (2006) Frequency of calls to “on-call” house officer pagers at Auckland City Hospital, New Zealand. NZ Med J 119:U1913Google Scholar
  12. 12.
    Nguyen TC, Battat A, Longhurst C et al (2006) Alphanumeric paging in an academic hospital setting. Am J Surg 191:561–565CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Shaun P. Patel
    • 1
  • Jay S. Lee
    • 1
  • David N. Ranney
    • 1
  • Shaza N. Al-Holou
    • 1
  • Christopher M. Frost
    • 1
  • Meredith E. Harris
    • 1
  • Sarah A. Lewin
    • 1
  • Erqi Liu
    • 1
  • Arin Madenci
    • 1
  • Allen A. Majkrzak
    • 1
  • Jessica Nelson
    • 1
  • Sarah F. Peterson
    • 1
  • Kerri A. Serecky
    • 1
  • David A. Wilkinson
    • 1
  • Brandon M. Wojcik
    • 1
  • Michael J. Englesbe
    • 2
    Email author
  • Raymond J. Lynch
    • 2
  1. 1.University of Michigan Medical SchoolAnn ArborUSA
  2. 2.Department of SurgeryUniversity of Michigan Medical SchoolAnn ArborUSA

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