Out-of-hours communication between healthcare professionals in an acute hospital setting in Ireland

Background The challenge of maintaining standards of safety in hospitals whilst delivering effective patient care during out-of-hours service periods is well documented. Communication between healthcare professionals (HCPs)... [ view full abstract ]

Background

The challenge of maintaining standards of safety in hospitals whilst delivering effective patient care during out-of-hours service periods is well documented. Communication between healthcare professionals (HCPs) during this period is one of many important processes that impact upon timely and appropriate delivery of patient care.

Aims and objectives

To investigate out-of-hours communication processes between Registered General Nurses and Doctors in a University Teaching Hospital in Ireland.

Design

The study design was mixed methods and underpinned by a participatory approach. Purposive sampling was used. Quantitative data included self-report doctor work requests by doctors (via mobile phone app) and nurses (using a paper based tool). Analysis included a range of descriptive and bivariate tests. Interviews and focus groups with doctors and nurses were analysed thematically. Ethical approval was granted by author’s academic institution.

Findings

The participants reported using traditional methods of communicating. The bleep system and its centrality to communication out-of-hours emerged as a significant issues of concern for almost all participants. Doctors struggled with the excessive volume of bleeps and the inability to prioritise the bleeps from the information available. Nurses were indeed often viewed as the coordinator of information but expressed concern that the traditional strategies for exchanging information were falling short of requirements. Both the doctors and nurses reported that many of the tasks the doctors were asked to do should have been performed by the primary team during the day. Some issues of safety or potential for missed care were revealed.

Conclusions and implications
These findings indicate a number of systems level changes that could improve the quality and flow of out-of-hours communication between staff including adjustments to handover process, bleep system and work flow of routine medical work.