Ophthalmology on Call: Evaluating the Volume, Urgency, and Type of Pages Received at a Tertiary Care Center

Abstract

Background: A significant proportion of on-call resident workload is related to answering and managing pages. Ophthalmology residents see high volumes of patients on call, but little is known about the profile of pages they receive. The objective of this study is to characterize the volume, type, and urgency of pages received by the ophthalmology on-call service. Methods: A retrospective review of on-call pager log sheets and patient charts was performed at a single academic institution. Data were collected from July to December 2019, sampling the first seven days of each month. Data collected for each page included date/time of day, source, and primary concern. For each page leading to a patient encounter, time from page to patient assessment, patient demographics, and final diagnosis were recorded. Continuous variables were reported as mean values, whereas categorical variables were presented as percentages. A two-sample t-test and single-factor analysis of variance were employed. Results: Over 42 days, 1108 pages were received. Over half of these calls required patient assessment, 71% of which were seen the same day. On average, 26 pages were received in 24 hours. Daytime weekday hours were significantly more busy than weekday nights or weekends (p<0.001). Patients and the emergency department each accounted for almost one-third of calls received. Retina- and cornea-related consults were most common. Conclusions: Pager volumes in ophthalmology are high and on-call patient volumes are rising. Answering pages increases the on-call resident’s workload and has a negative impact on clinic flow. These data can be used to inform resident curriculum development, hospital system changes, patient education regarding appropriate paging, and medical school teaching.

Investigating Weekend Effect in the Management of Upper and Lower Extremity Degloving Injuries

“…Possible contributors include differences in overall ED volume on weekends, including more nonemergency visits and a higher volume of pages to surgical subspecialty services, which together may impact quality of care received by patients experiencing degloving injuries on weekends. 24 , 25 Increased cognitive load, which physicians may experience in a busy weekend ED, is associated with differences in decision-making. 26 In high-demand clinical situations, the use of simulation training, mobile clinical support tools, and standardized protocols have been useful in decreasing cognitive load and increasing accuracy and efficiency of treatment decisions.…”