Dr. Joseph Sirven: Paging Dangerously

Published: Wednesday, July 26, 2017 - 9:09am
Updated: Wednesday, July 26, 2017 - 9:23am
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Dr. Joseph Sirven
Dr. Joseph Sirven

Text paging can be dangerous in hospitals, as KJZZ's medical commentator, Dr. Joseph Sirven explains.


The pager reads: “Patient seizing, blood pressure elevated, please advise!”

I was concerned. I picked up the phone to respond — except for one detail: which patient? I called a nursing unit, yet no one admitted to sending the text. Adding to the mystery, nurses where I work do not send me text pages.

A few minutes later I received another page. “Never mind,” was all it said. I still have no clue who sent it.

Text paging medical information has been a medical practice for years given that it saves time by eliminating a phone call. But my example shows where a text page could be a recipe for disaster.

Researchers from the University of California San Francisco had similar trepidations and they recently analyzed hospital text paging messages. Nearly 600 pager messages relating to 217 patients were evaluated. Three themes emerged.

First, there’s a lack of standardization in terms of abbreviations and identification of patients. Second, an uncertainty about the urgency of the problem and lastly, huge communication gaps including which patient was being referred to. My patient is one example.  Another example from the study is where a nurse asks a doctor by text whether IV blood pressure lowering medication can be delivered to a patient but no patient is identified in the text. Yikes!

Not surprisingly, the authors concluded that text paging introduces both unneeded ambiguities and the potential for delaying treatment. Plus these pages are off the grid and not documented in the medical record because, like Snapchat, there is no memory of what was transmitted.

Despite all of the remarkable advances in communication, pagers continue to survive in hospitals — they’ve been used there since 1949. They’re an efficient way of reaching someone. I still use one myself.

Yet, sometimes in that rush to save time, there is no substitute for the oldest communication tool of all — the human voice.

Dr. Joseph Sirven is a neurologist at the Mayo Clinic.

Science