Distractions During Patient Handoff: The Application-Based Messaging Volume on General Surgery Interns

Abstract

Mobile phone-based paging systems have become increasingly common for communication within hospitals. Surgical interns receive the most pages, and our aim is to objectively quantify and evaluate this burden to allow for targeted improvement. We performed a retrospective review of our institutions mobile phone-based paging system data (Halo Health, Cincinnati, OH) from July 2019 to September 2019. Carolinas Medical Center, Charlotte, NC, USA. Seven general surgery postgraduate year (PGY) 1 residents. Forty-five thousand eight hundred and one messages met inclusion criteria, with 27,397 messages received and 18,404 sent. PGY 1 residents each received an average of 48 ± 41 messages per shift, with 8 ± 17 messages per day while off-duty. Night shifts averaged more messages than day shifts (80 ± 39 vs 38 ± 32, p < 0.0001), and had more shifts with high message volume (30% vs 11%, p = 0.0005). Evaluating the total number of messages received per minute of the day, the largest number of high-volume message intervals (21) occurred during patient handoff (1700-1900 hours). Most messages were sent by nursing staff (55.8%), followed by medical providers (38.2%). PGY 1 residents receive a large number of pages using a messaging application, with many occurring at critical times. Residents received a higher volume of pages on night shifts, during patient handoff, and while off-duty. Since most pages are from nursing staff, targeted education and preventative actions may help decrease the volume of pages during these critical times.