Pd30-11 turning the page again: decreasing inappropriate after-hours pages

You have accessJournal of UrologyCME1 Apr 2023PD30-11 TURNING THE PAGE AGAIN: DECREASING INAPPROPRIATE AFTER-HOURS PAGES Rachel Mann, Brent Cleveland, Jacob Albersheim, and Martin Koyle Rachel MannRachel Mann More articles by this author , Brent ClevelandBrent Cleveland More articles by this author , Jacob AlbersheimJacob Albersheim More articles by this author , and Martin KoyleMartin Koyle More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003316.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Taking after-hours call is an important and necessary part of resident training, however this is a key source of burnout. In 2003, the ACGME implemented resident work hour restrictions, requiring programs to implement solutions to cover after-hours call burden without violating duty hour limits. Even with optimal sleep hygiene, overnight paging contributes to fatigue. We sought to decrease the number of inappropriate pages after-hours by 50% to promote resident sleep and decrease burnout. METHODS: Over 9 weeks, all after-hours pages to the on-call resident at the University of Minnesota Department of Urology were documented. Pages were deemed “appropriate” or “inappropriate” based on three independent reviewers. The source of each page was documented and three were chosen for implementation of interventions: the wards, the call triage center, patient phone calls. A single intervention was implemented for each source. We allowed a 6-week period for implementation of these interventions, then performed another 9-week data collection cycle for after-hours pages. We compared total number of pages and inappropriate pages across sources for each cycle. RESULTS: 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.” The 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%), followed by the wards (56.0%), patient phone calls (51.8%), and the emergency department (44.8%). After implementation of our interventions, 42 shifts were recorded. The mean number of pages per shift decreased to 5.9 (range 1-20), and 25.0% of pages were deemed “inappropriate.” All domains saw a decrease in inappropriate after-hours pages (Figure 1). CONCLUSIONS: By improving communication to nurses, call center personnel, and patients, inappropriate after-hours pages decreased by 52.6%. Future studies are needed to assess if resident burnout was impacted and if the impact was sustainable over time. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e835 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rachel Mann More articles by this author Brent Cleveland More articles by this author Jacob Albersheim More articles by this author Martin Koyle More articles by this author Expand All Advertisement PDF downloadLoading ...