Can mobile technology improve response times of junior doctors to urgent out-of-hours calls? A prospective observational study

QJM. 2014 Apr;107(4):271-6. doi: 10.1093/qjmed/hct242. Epub 2013 Dec 3.

Abstract

Background: The Hospital at Night system has been widely adopted to manage Out-of-Hours workload. However, it has the potential to introduce delays and corruption of information. The introduction of newer technologies to replace landlines, pagers and paper may ameliorate these issues.

Aim: To establish if the introduction of a Hospital at Night system supported by a wireless taskflow system affected the escalation of high Early Warning Scores (EWSs) to medical attention, and the time taken to medical review.

Design: Prospective 'pre and post' observational study in a teaching hospital in the UK.

Methods: Review of observation charts and medical records, and data extraction from the electronic taskflow system.

Results: The implementation of a technology-supported Hospital at Night system was associated with a significant decrease in time to documentation of initial review in those who were reviewed. However, there was no change in the proportion of those with a high EWS that were reviewed, and throughout the study a majority of patients with high EWSs were not reviewed in accordance with guidelines.

Conclusion: Introduction of a Hospital at Night system supported by mobile technology appeared to improve the transfer of information, but did not affect the nursing decision whether to escalate abnormal findings.

Publication types

  • Observational Study

MeSH terms

  • After-Hours Care / organization & administration*
  • After-Hours Care / standards
  • Computers, Handheld
  • Emergencies
  • England
  • Hospital Communication Systems / organization & administration*
  • Hospitals, Teaching / organization & administration*
  • Hospitals, Teaching / standards
  • Humans
  • Kaplan-Meier Estimate
  • Medical Staff, Hospital / organization & administration*
  • Medical Staff, Hospital / standards
  • Outcome Assessment, Health Care / methods
  • Personnel Staffing and Scheduling / organization & administration
  • Prospective Studies
  • Time Factors
  • Wireless Technology / organization & administration*