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(Chest. 1999;116:1019-1024.)
© 1999 American College of Chest Physicians

Differences in the Response Times of Pages Originating From the ICU*

Marc Moss, MD; Terence K. Trow, MD, FCCP and Nancy Clardy, RN

* From the Department of Medicine (Dr. Moss), Division of Pulmonary and Critical Care, Emory University School of Medicine, Atlanta, GA; Crawford Long Hospital of Emory University (Dr. Moss and Ms. Clardy) and the Carlyle Fraser Heart Center (Dr. Moss), Atlanta, GA; and the Department of Medicine (Dr. Trow), Division of Pulmonary and Critical Care Medicine, Danbury Hospital, Danbury, CT.

Correspondence to: Marc Moss, MD, Crawford Long Hospital of Emory University, Suite 5310, 550 Peachtree St, NE, Atlanta, GA; e-mail: marc moss{at}emory.orgmoss@emory.org

Study objectives: To determine whether the type of paging system causes significant differences in the response time by physicians to their pages in an ICU setting.

Design and setting: Prospective cohort study performed in the ICU of two university-affiliated hospitals. All pages were classified by several different variables, including the type of paging system: direct paging if a nurse or hospital operator could directly place the page, or indirect paging if a nurse or hospital operator was required to contact the physician's office or a private answering service who would then independently contact the physician. The main outcome measure was physicians' response time, in minutes, to pages originating from the ICU.

Results: During a 100-day period, 402 pages were sent and answered by 166 different physicians (87 attending physicians and 79 housestaff/physician assistants). The median response time for all pages was 3 min with a 25 to 75% quartile of 1 to 8 min. Twenty-five percent of the pages placed through an indirect system were associated with a response time of >= 29 min. In a multivariate model with the response time dichotomized at >= 15 min ("slow") or < 15 min ("adequate"), pages placed through an indirect system were answered significantly more slowly than pages placed through a direct system (p < 0.001; odds ratio, 4.36; 95% confidence interval, 2.05 to 9.29). Pages answered in an adequate amount of time were also associated with a significantly higher degree of overall nursing satisfaction with the care delivered by the physician in response to the specific page when compared with pages answered in a "slow" manner (p < 0.001).

Conclusions: Physicians who use an indirect paging system are significantly slower in their response to ICU pages when compared with physicians who utilize a direct paging system. These results may lead to improvements in paging systems used by physicians who care for patients in an ICU setting.

Key Words: hospital communication systems • ICU • ICU organization • hospital personnel • hospital medical staff






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