title: Why do we still page each other? Examining the frequency, types and senders of pages in academic medical services.
abstract: Paging still represents an important form of communication within hospitals, but it results in interruptions, and other more modern approaches could be superior. This study aims to describe how paging is currently used in an academic medical centre, including the frequency, type, urgency and sender of pages, so that improvements in communication can be better informed.
  
  
  
  In order to understand what communication needs paging fulfils in a modern academic medical centre, we analysed a database of 1252 pages sent to internal medicine residents within an academic medical centre. We assessed all pages from 3 separate general medicine rotations over a total of 56 days encompassing 602 h.
  
  
  
  Residents were paged an average of 22.4 times per day, with a maximum of 50 pages per day. Most pages were deemed clinically relevant (76%) and important (76%) to patient care. Overall, 59% of pages required a response. A mean of 7.7 pages were sent per patient, up to a maximum of 70 pages for one patient. Nurses (28%), consultants (16%) and the clinical laboratory (15%) were responsible for the majority of pages. Almost all pages from nurses (82%) and consultants (82%) required a response. Regionalised services had significantly fewer pages per day than non-regionalised services (19 vs 37, p≤0.00001).
  
  
  
  Paging remains widely used for communications within hospitals about patient care. Although the majority of pages were judged to be clinically relevant and important, they frequently required a response potentially leading to interruptions in workflow, and communication waste. Paging rate and volume has not decreased in 25 years despite significant penetration of newer technologies. For the majority of current uses of pages, we believe other approaches may now be more appropriate. Regionalisation significantly reduces the number and urgency of the pages.
authors.affiliation: General Internal Medicine, Brigham And Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Narath
authors.identifier: 0000-0002-6601-6035
authors.initials: N
authors.lastname: Carlile
authors.affiliation: Division of Global Health and Social Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Rhatigan
authors.affiliation: Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D003142:Communication; D006747:Hospital Communication Systems / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D007396:Internship and Residency / Q000706:statistics & numerical data
keywords: Communication; Hospital medicine; Information technology; Interruptions; Teamwork