Perfecting Patient Communication By Optimizing the Nurse Call System

    • May 13, 2010

Intervention title:
Perfecting patient communication by optimizing the nurse call system—Children’s Hospital Boston, Boston, Mass.

Increase time nurses spend at the bedside by improving hospital’s telecommunication system.

Developed new process to improve utilization and functionally of hospitals call system that patents use to request assistance from nurses.

Improved response time to patient needs and streamlined communication

Children’s Hospital Boston
300 Longwood Avenue
Boston, MA 02115
P: (617) 355-6000

From the C-Suite:
“Efficiently responding to patients’ needs is one of our utmost priorities. Before implementing the new process for our call system, both our patients and nurses were often left frustrated and confused by misplaced calls and disconnections. By implementing this straightforward and cost-effective change, we have been able to increase nurses’ time spent at the bedside and improve our patients experience.”

Eileen Sporing, M.S.N., R.N.
Chief Nursing Officer

Children's Hospital Boston is a 396-bed not-for-profit comprehensive center for pediatric health care.

Clinical areas affected:

  • All medical-surgical units

Staff involved:

  • Nurses
  • Administrative staff
  • IT department

Pinpointing the problems with the system and the development of a new process took two months. Rollout and implementation including training sessions with staff occurred over one month.

Deborah Powers, R.N., B.S.N.
Nurse Manager
P: (617) 355-9648

Innovation implementation:
The nurse call system used at Children’s Hospital Boston proved flawed when calls between nurses and patients were frequently disconnected, administrative staff could not reach nurses and had to rely on the hospital page system or nurses were frequently called to patients’ rooms they were not assigned to or calls that could have been answered by a clinical assistant. It was clear to both the nurses and administrative staff that patients’ needs were not being met with the current communications breakdowns and improvements needed to be developed and implemented.

To begin the process of improving the nurse call system, staff met with the hospital’s telecommunication vendor to ensure they were aware of all of the services and options available with the existing system. Working with the vendor, a new process for utilizing the nurse call system was developed to streamline communications.

Under it, when a nurse starts a shift, they are assigned a fully-charged phone that the administrative staff records on the phone locator board. In addition, the charge nurse ensures that all spectralink phone numbers are recorded on a separate assignment sheet. When patients call for assistance, the administrative staff person on screens the call to determine what assistance is needed and by whom. Once the need is determined, the administrative staff acts according to patient care needs. This may involve immediately contacting the nurse assigned to the patient on their own phone. If the assigned nurse is not available, she informs the administrative staff who will ask either the charge nurse, the next nurse in rotation or the clinical assistant to respond to the request. At the end of the nurse’s shift, their assigned number is relinquished to a colleague and the switch is noted on the locator board and charge nurse assignment sheet. The new process worked so well to improve communications that additional phones were purchased for clinical assistants.

Advice and lessons learned:

  1. Rely on vendors to identify solutions. Since you are paying for a service to help improve your work, ask the vendor to troubleshoot problems and develop solutions that work for your specific institution.
  2. Convene multiple training sessions. As new staff come on board, it’s important to train them on the new system and invite existing staff to participate for a refresher. These sessions will also allow you to revisit the system and make sure that it is working properly.
  3. Be patient. It may take time for everyone to become acquainted with the new system. Change occurs over time and patience on everyone’s part will help ensure success with any new innovative idea. Don’t take staff errors as stubborn resistance, though do expect some push back.

Cost/benefit estimate:
Time spent at the bedside increased by more than 10 percent and overall patient satisfaction increased by nearly nine percent. New phones that are now carried by the clinical assistants cost $1,000 each.