Mobile Communication in Hospitals: What is the Problem?

Mobile Communication in Hospitals: What is the Problem?

Terje Solvoll (Norwegian Centre for Integrated Care and Telemedicine, Tromsø Telemedicine Laboratory, University hospital of North Norway & Department of Computer Science, University of Tromsø, Norway)
DOI: 10.4018/978-1-4666-2190-9.ch014
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The work setting in hospitals is communication intensive and can lead to significant difficulties related to interruptions from co-workers. Physicians often need information fast, and any delay between the decision made and the action taken could cause medical errors. One suggested solution for this problem is to implement wireless phone systems. However, psychological theory and empirical evidence, both suggest that wireless phones have the potential of creating additional problems related to interruptions, compared to traditional paging systems. The fact that hospital workers prefer interruptive communication methods before non-interruptive methods, amplifies the risk of overloading people when phones are widely deployed. This challenge causes some hospital staff to resist the diffusion of wireless phones, and a key is how to handle the balance between increased availability, and increased interruptions. In this chapter, the authors present solutions based on context aware communication systems, aiming to reduce interruptions.
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Physicians’ working conditions rely on mobility. They move frequently between in-patient ward, out-patient ward, emergency ward, operating theatres, etc., and often do not stay more than a few minutes in the same location. High mobility requires mobile communication systems, which enables physicians to communicate with colleges at any time and place, to avoid any delay between the decision made and action taken. Such delays could result in medical errors (Hersh, et al., 2002), and mobile communication systems have been suggested as a solution to improve communication in hospitals (Coiera & Tombs, 1998). The challenge when deploying mobile communication systems is to handle the balance between the increased availability and possible interruptions (Scholl, et al., 2007; T. Solvoll & Scholl, 2008; Terje Solvoll, et al., 2010, 2012). Most hospitals still rely on a mobile communication infrastructure with dedicated devices for each role, where pagers are the most dominant mobile communication device.

Pagers provide a cheap and reliable way for contacting staff. They are ubiquitous and several physicians carry numerous pagers simultaneously to cover the various work roles they have been assigned. Pagers suffer from a number of problems due to their simplicity. The most obvious limitation is that it requires the staff to locate a telephone (landline or wireless) in order to respond to a page. This might cause unnecessary delays and communication overhead, since the person placing the page is not always near the phone when the page is returned (Spurck, Mohr, Seroka, & Stoner, 1995). Pagers also create a large amount of unnecessary interruptions (Blum & Lieu, 1992; Katz & Schroeder, 1988), which is unpleasant and can cause medical errors (Hersh, et al., 2002).

The most intuitive solution to improve the communication situation in hospitals is to provide physicians with wireless phones. However, phones can be even more interruptive than pagers (Scholl, et al., 2007; T. Solvoll & Scholl, 2008; Terje Solvoll, et al., 2010, 2012). In (Scholl, et al., 2007) a physician states that; “with a pager you just have to glance down at your coat pocket to see who is paging, while with a phone, you have to pick it up from your pocket to see who is calling. Having done that, it is easier just answering and explaining that you are busy” (T. Solvoll & Scholl, 2008).

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