title: Multimodal observational assessment of quality and productivity benefits from the implementation of wireless technology for out of hours working.
abstract: OBJECTIVE
  The authors investigated if a wireless system of call handling and task management for out of hours care could replace a standard pager-based system and improve markers of efficiency, patient safety and staff satisfaction.
  
  
  METHODS
  Prospective assessment using both quantitative and qualitative methods, including interviews with staff, a standard satisfaction questionnaire, independent observation, data extraction from work logs and incident reporting systems and analysis of hospital committee reports.
  
  
  METHODS
  A large teaching hospital in the UK.
  
  
  METHODS
  Hospital at night co-ordinators, clinical support workers and junior doctors handling approximately 10 000 tasks requested out of hours per month.
  
  
  METHODS
  Length of hospital stay, incidents reported, co-ordinator call logging activity, user satisfaction questionnaire, staff interviews.
  
  
  RESULTS
  Users were more satisfied with the new system (satisfaction score 62/90 vs 82/90, p=0.0080). With the new system over 70 h/week of co-ordinator time was released, and there were fewer untoward incidents related to handover and medical response (OR=0.30, p=0.02). Broad clinical measures (cardiac arrest calls for peri-arrest situations and length of hospital stay) improved significantly in the areas covered by the new system.
  
  
  CONCLUSIONS
  The introduction of call handling software and mobile technology over a medical-grade wireless network improved staff satisfaction with the Hospital at Night system. Improvements in efficiency and information flow have been accompanied by a reduction in untoward incidents, length of stay and peri-arrest calls.
authors.affiliation: Respiratory Biomedical Research Unit, University of Nottingham, Nottingham, UK.
authors.forename: John D
authors.initials: JD
authors.lastname: Blakey
authors.forename: Debbie
authors.initials: D
authors.lastname: Guy
authors.forename: Carl
authors.initials: C
authors.lastname: Simpson
authors.forename: Andrew
authors.initials: A
authors.lastname: Fearn
authors.forename: Sharon
authors.initials: S
authors.lastname: Cannaby
authors.forename: Petra
authors.initials: P
authors.lastname: Wilson
authors.forename: Dominick
authors.initials: D
authors.lastname: Shaw