title: Anonymity: an impediment to performance in healthcare.
abstract: Many teaching hospitals employ a care team structure composed of a broad range of healthcare providers with different skill sets. Each member of this team has a distinct role and a different level of training ranging from attending physician to resident, intern, and medical student. Often times, these different roles lead to greater complexity and confusion for both patients and nursing staff. It has been demonstrated that patients have a great degree of difficulty in identifying members of their care team. This anonymity also exists between nursing staff and other care providers. In order to better understand the magnitude of anonymity within the teaching hospital, a ten-question survey was sent to nurses across three different departments. Results from this survey demonstrated that 71% of nurses are "Always" or "Often" able to identify which care team is responsible for their patients, while 79% of nurses reported that they either "Often" or "Sometimes" page a provider who is not currently caring for a given patient. Furthermore, 33% of nurses felt that they were either "Rarely" or "Never" able to recognize, by face and name, attending level providers. Residents were "Rarely" or "Never" recognized by face and name 37% of the time, and interns 42% of the time. Contacting the wrong provider repeatedly leads to de facto delays in medication, therapy, and diagnosis. Additionally, these unnecessary interruptions slow workflow for both nurses and members of the care team, making hospital care less efficient and safe overall. Technological systems should focus on reducing anonymity within the hospital in order to enhance healthcare delivery.
authors.affiliation: Internal Medicine Residency Program, Department of Medicine, University of Colorado, Denver.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Karlsberg
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Colorado, Denver.
authors.forename: Read G
authors.initials: RG
authors.lastname: Pierce
keywords: IT; IT systems; anonymity; anonymous; communication; healthcare innovation; healthcare teams; hospital communication systems; information technology; interprofessional communication; nursing communication; paging; paging systems; provider recognition
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