Night-time communication at Stanford University Hospital: perceptions, reality and solutions

Abstract

A significant number of non-urgent pages are sent at night. These pages likely distract from acute issues that arise at night and place an unnecessary burden on night floats. Both behavioural and systemic adjustments are needed to address this issue. Possible interventions include integrating low-priority messaging into the electronic health record system and use of charge nurses to help determine urgency of issues and batch non-urgent pages.

General phenomenon and communication experience of physician and nurse in night shift communication: A qualitative study

“…Laura Rosenthal (Rosenthal, 2013) stated in his research that a rapid response quality improvement programme provides guidance for night shift care communication, reduces non‐emergency calls and allows nurses and doctors to focus on other priorities. More studies have shown that non‐emergency calls may cause the doctor to be fatigued and affect the patient's prognosis (Sun et al, 2018). Since night shift care communication is a communication in a special situation and time period, the timing is also an important issue.…”

“…These ways include integrating the low priority of the e‐health file system and helping the nurse determine the urgency of the problem. Researches abroad (Becker, 2013; Desjardins, Cardinal, Belzile, & McCusker, 2008; Sun et al, 2018) have studied night shift physician–nurse communication, and many indicate the existence of the physician–nurse communication barrier (Hansson, Arvemo, Marklund, Gedda, & Mattsson, 2010; Leonard, Graham, & Bonacum, 2004). More studies have indicated that there are various qualitative methods to study night‐time physician–nurse communication; however, there is still a lack of qualitative and interventional research on night‐time physician–nurse communication (De et al, 2013).…”

Understanding the means of communication between nurses and resident physicians in the modern world: A community-based university hospital survey results

“…As well, all the reported substitutive means of communication that basically relied on alternative means of communication failed to replace the conventional direct communication between RP and nurses and rather supported the fact that its role is complementary rather than substitutive one [ 4 – 7 ].…”

“…And while we have better understood the value of this communication and the teamwork between nurses and residents, especially to ensure patient safety and a high value of care, newer means of communication have been implemented, typically through the technology available in the medical field, namely the electronic medical records (EMR) [ 2 , 3 ]. Many published data and studies in the literature have explored different means of communication between nurses and resident physicians (RP) [ 4 – 7 ]. While many agreed that there is a large number of calls or pages for non-urgent matters, others suggested using text messages or the EMR to decrease the burden of direct calls through pages and/or phone calls between nurses and residents [ 4 – 7 ].…”

“…Many published data and studies in the literature have explored different means of communication between nurses and resident physicians (RP) [ 4 – 7 ]. While many agreed that there is a large number of calls or pages for non-urgent matters, others suggested using text messages or the EMR to decrease the burden of direct calls through pages and/or phone calls between nurses and residents [ 4 – 7 ]. These suggestions are to decrease that burden of calls and direct communication and improve the workflow while sustaining a high level of patient care and safety.…”