There was an urgent need for a new paging system.
Nurses were miserable because nobody was answering them in a timely fashion.
Doctors were annoyed because when they received a page they never knew if it
was something that could wait or something that needed urgent attention. There
was a need for change but quite simply nobody seemed to have time to figure out
a solution. Tensions seemed to be rising
as the nurses and doctors seemed to be creating this unspoken war with each
other.
Then one day like magic the doctors and nurses
started to talk, yes talk! They formed a little coalition that decided enough
was enough and a new system needed to be put in place. It seemed like the
perfect time for a change since both groups wanted something new so everyone
seemed to be on board.
A few months ago a group of nurses came together
over lunch and talked about a new vision for paging. They discussed terms that
would make it easy for doctors to figure out what was needed and how quickly
they needed to respond. There were also rules developed about what would happen
if there was no response and a three strikes you’re out consequence if there
was no response after a second attempt. The plan was given to the doctors and the
nurses held their breath.
After several days of playing the waiting game the
doctors returned their feedback. They wanted the nurses to use the terms stat,
urgent and routine to indicate the time frame in which they needed to
respond. Stat indicates an immediate
response is needed, urgent means fifteen minutes or less and routine gives the
doctor the entire shift to respond. The nurses would need to decide if
something could wait or if it couldn’t. In addition to the terminology, pages
needed to include the patient last name, room number, issue and the nurse name
and a contact phone number. If by chance a physician did not respond in the
given time frame a second page was allowed and needed to be sent stat and
second attempt. This would tell the physician, “Hey, we sent you a page and
have not heard back.” If the physician still did not respond in the time frame
after a second attempt, a supervisor could be notified.
The nurses communicated that they were ecstatic
about this new plan and told the physicians that they were very happy with the
new plan. They proposed a trial run to
see how the new paging system would go. Only one floor participated and it was
a huge success. Once the trial period was over the new paging system was
released to all floors. The system is now policy and both doctors and nurses
are very happy with the implemented change. The doctors even chipped in and
offered a pizza party to the floor with the most correct pages sent in a month.
(Of course my floor won that party.)
The system has been in place now for about six
months and everyone is happy and satisfied. The nurses are getting page
responses quickly and efficiently and the doctors can now rest easy that they
have a time frame to answer non urgent pages. It could be said that they lived
happily ever after but that would be too cliché. There will always be things
that need fixing or updating but for now the doctors and nurses are coexisting
in a positive work culture. As Kotter (2014) explains in his book Leading Change, constantly seek
opportunities, identify initiatives to capitalize upon, and complete them
quickly.
Kotter, J. (2014). Leading change. Watertown, Mass.: Harvard Business Review Press.
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