Presentation Authors: Jeremy Brown, Zahabiya Campwala, Akin Amasyali, Mohammad Hajiha, Muhannad Alsyouf, Phillip Stokes, Ashley Li, Hyelin You, Milan Shah*, Samuel Abourbih, D. Duane Baldwin, Loma Linda , CA
Introduction: Improving communication between doctors and nurses in an outpatient clinical setting has the potential to improve efficiency, quality and patient satisfaction while decreasing costs. The purpose of this study is to evaluate the impact of a two-way radio communication system in the urology outpatient clinic setting, and its effect upon efficiency and patient satisfaction.
Methods: All members of the urologic clinical team including attending physicians, fellows, clinic nurses and clinic medical assistants (MA) wore two-way radio headsets during typical outpatient clinics. In half of the clinic visits the nurse&[prime]s and MA&[prime]s radios were not turned on (controls), while in half the visits all radios were on (experimental setting). Patients and reviewers were blinded to whether the radios were operational. Clinical efficiency was compared during 8 different clinic days over an 8-week period. Primary endpoints included the time from physician completing discharge documents to the patient receiving the discharge paperwork, and the time from physician completing discharge documents to clinic discharge. Secondary outcomes included a subjective questionnaire for patient and staff members regarding the satisfaction with the two-radio system. Statistical analysis was performed using a Mann-Whitney U test, with p < 0.05 considered significant.
Results: Visit times for 110 patient visits during 8 different urology clinics were compared including 55 with the two-radios on, and 55 visits where the nurse and MA radios were turned off. Use of the two-way radio communication decreased the time between the printing of discharge documents and the patients receiving the documents by 65% (2.3 minutes versus 6.75 minutes respectively; p < 0.001). In addition, two-way radio communication resulted in a 57% decrease in total discharge time (3.3 minutes versus 7.8 minutes respectively; p < 0.001). 92% of patients felt the doctor&[prime]s use of the radio did not impact patient communication with the doctor. During the period of radio use, the physician&[prime]s overall satisfaction ranking rose from 13/15 to 5/15 compared to other physicians in the group. 83% of staff agreed or strongly agreed that two-way radio use improved clinic efficiency.
Conclusions: Implementation of two-way radio communication in an outpatient clinic setting showed a significant decrease in both patient wait times and total discharge time. This improved clinic efficiency improved patient and staff satisfaction and has the potential to improve quality and reduce costs.