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Turning the page on hospital communications slowly
  1. Robert Wu
  1. Correspondence to Dr Robert Wu, Division of General Internal Medicine, University Health Network, 200 Elizabeth St - 14EN222, Toronto, Ontario, M5G 2C4, Canada; robert.wu{at}

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In hospitals, breakdowns in communication has been found to be a major source of errors.1 Communication between clinicians can occur at scheduled times or rounds, through face-to-face meetings or may be facilitated through the use of communication tools such as pagers. For the latter, often urgent communication between clinicians about a patient is required. Problems in communication can result in a failure to rescue or result in poor coordination of care.2

In this issue of the journal, two articles describe the communication process within hospitals from different perspectives. Carlile et al3 looked at paging from the physician's perspective and analysed 1252 pages sent to internal medicine residents within an academic medical centre. They found that paging still occurs frequently, with residents receiving an average of 22 times per day at an average rate of 2.2 pages per hour. Approximately 75% of pages were both clinically relevant and important to patient care (as judged by the investigators). Most communications required a response, especially those from nurses (82%) and from consultants (also 82%). Of note, regionalised services—services which were located on a single ward—had approximately half the number of pages per day than services located on multiple wards (19 vs 37 pages per day; p≤0.00001).

In the second article, Kummerow Broman looked at communication from the nursing perspective and compared communication processes in wards where nurses carried mobile phones to wards without them.4 They compared whether the response to the communication occurred, whether the response interrupted patient care, and if a repeat page was required. Nurses paged providers on average 2.9 times per shift. There was no difference in acknowledgement of messaging (89% vs 74%), repeat paging (14% vs 19%), time to provider acknowledgement (7 min vs 12 min), or patient care interruptions to respond to …

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