Turning the “Page” Again: Decreasing Inappropriate After-Hours Pages

• Published in: Urology (Ridgewood, N.J.) N.J.), 2024-12, Vol.194, p.357-361
• Main Authors: Mann, Rachel A., Cleveland, Brent E., Albersheim, Jacob A., Koyle, Martin A.
• Format: Article
• Language: English
• Subjects: After-Hours Care - standards; After-Hours Care - statistics & numerical data; Humans; Internship and Residency; Minnesota; Urology
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2024.08.002

To decrease the number of inappropriate pages after-hours by 50%. Over 9 weeks, after-hours pages to the on-call resident at University of Minnesota Department of Urology were documented. Pages were deemed “appropriate” or “inappropriate” by 3 independent reviewers. The source of each page was reviewed and after several plan-do-study-act (PDSA) cycles, 3 separate interventions were created, directed at floor nursing, patient phone calls, and the call triage center. After a 6-week implementation period, data were re-collected for 9 weeks. Descriptive statistics were generated, and a Mann-Whitney U test was used to compare inappropriate pages pre- and post- interventions. In phase I, 48 shifts were recorded. The mean number of pages per shift was 8.9 (range 1-27), with 52.7% of pages considered “inappropriate.” Most pages came from the wards (48.9%) followed by the emergency department (20.4%), patient phone calls (19.4%), and the call center (2.6%). From these domains, the call center had the highest proportion of inappropriate pages (90.9%). In phase II, 39 shifts were recorded. The mean number of pages per shift decreased to 6.0 (range 1-20), and inappropriate pages per shift decreased by 68.4%, (P