A team of nurses and physicians representing house staff, attendings, and nurses from our clinical services met in December 2002 to review the current challenges with nurse-physician communication. Such issues as physicians not being available, a large number of pages from the same pod, pages that could be improved, and not knowing who is covering some services were discussed. The team has developed the following guidelines as a mechanism to improve patient care by improving team communication.
Guidelines for excellent communication
- Communication must focus on the needs of the patient;
- Paging via computer, rather than through operators http://ppd.partners.org is encouraged;
- Always use respect and telephone etiquette;
- If possible, attempt to consolidate pages to one individual within a pod, i.e., paging for several patient issues (non-urgent matters) at the same time;
- Messages should be concise and accurate, especially given limitations of text paging;
- Clinicians must leave legible notes, name, and page number on paper;
- Physicians must maintain accurate listing of who is on call at http://ppd.partners.org/oncall by using oncalledits@partners.org;
- The person who pages should make every effort to be readily available to take the call when the person paged responds. Let others know you have paged someone;
- Operating surgeons and proceduralists must be able to answer pages or have a covering physician or nurse answer pages while in surgery or performing procedures;
- Communication associated with patient transfers and consultations should be between attending physicians; and
- Be mindful of patient confidentiality.
Ideal pages should include:- Call back number and name of person who paged
- Name of the patient
- Location of the patient
- Severity of the problem '
- The problem
- Response time expected
Examples of Ideal Pages:
Example A
27910
B Goldszer, 14A; T Bradshaw; Urgent;
Unable to move r arm well for 3 hours; please call
Example B
26815
D Leven, 7C; re B Sanders; Ready to go home,
Needs DC Orders ASAP; no return call needed.
Please review these guidelines with all members of your staff.
If you have any questions or suggestions please contact Debra Leven, MBA (dleven@partners.org), or Robert C. Goldszer MD, MBA (rgoldszer@partners.org).