The Hospital for Special Surgery in New York City switched from pagers to cell phones and saved thousands of dollars.
The improvement and consolidation in hospital communications also enhanced care, making it more patient-centric.
It seems like a simple concept to switch messages from pagers to physician cell phones, but implementation was anything but easy. It changed the clinical communication strategy for one of the world’s largest academic medical centers for musculoskeletal health.
The hospital performs about 32,000 orthopedic surgeries a year, according to Nick Wirth, director of Operational Excellence. About half of those are inpatient and the average length of stay is three days.
“It’s just as important as throughput through an ER,” Wirth said of having a smooth process for patients from pre- to post-surgery.
With the hospital handling about 24,000-plus conversations per month, it was important for physicians to get high-priority messages faster.
On external after-hours calls, there was no way to differentiate whether the call was coming from a patient who had a question, a patient who urgently needed treatment for sepsis, another healthcare facility, or from someone else.
“With a pager, you have a one-way communication,” Wirth said. “If you get three pages at once, sometimes all you have is a call-back number. You call back the first number.”
Retrieval times were high. Though Wirth said there was no way to measure how long it took between a page and call-back, the average retrieval time using cell phones is a little over three minutes and is much faster.
Under the new cell phone system, physicians can triage three messages. The phone system has built-in critical message types and protocols so that high priority calls are returned within five minutes.
For all calls, the system automatically sends an acknowledgment that the message was received.
The hospital began working last year to install the technology to centralize a lot of the call center management and to move messages from pagers to a secure cell phone.
Now, if a patient or someone else calls the hospital after-hours, the staff person answering the phone routes the call directly to the person on-call, Wirth said. The message generates a text or secure voicemail on the phone through a secure application on a mobile device.
The system saved only for no longer paying $100 per page, but the organization had 1,700 pagers.
“For 40 to 42 different practices, the average cost savings for the year was $3,000,” Wirth said. “The money saved was worth the investment.”
The health system began on the outpatient side. In 2018, they are moving towards bringing inpatient and outpatient into one platform.
Other systems considering the move need to make sure the infrastructure for wifi is up to speed and that there is great coverage. There also needs to be a discussion about installing the new system on private devices.
Beyond the savings, the Hospital for Special Surgery has created a higher level of patient safety for postoperative patients.
The hospital has historically had high patient satisfaction scores, Wirth said. The levels have risen in the areas of the hospital response to concerns and complaints and in its handling of emotional needs.
“The transformation we went through,” Wirth said, “there’s some real positive results.”
Wirth will be speaking in the HIMSS18 session, “Standardizing clinical communications improves patient care,” at 10 a.m. March 8 in the Sands Showroom.