On-call physician responses to after-hour calls from nurses on general medicine units

Author: Karen K. Pancheri

Primary Advisor:

Committee Members:

Masters thesis, The University of Texas School of Health Information Sciences at Houston.

Communication was the root cause of 60-65% of sentinel events that occurred between 1995 and 2003, according to The Joint Commission on Accreditation of Healthcare Organizations [1]. Communication-caused errors were almost twice as common as errors due to poor medical skills in a study of Australian hospitals [2].  Communication problems between physicians and nurses were associated with 37% of the total errors collected over a four month period [3].

The importance of communication between physicians and nurses intensifies during the evening and night hours in the hospital setting. Many times the physicians on-call during these hours have little prior knowledge of the patient being treated because they are not part of the primary care team. One study established that 14% more preventable medical errors occurred in patients covered by on-call physicians than in patients covered by primary care physicians [4]. One major difference between the two groups is the depth of knowledge about the patient. Communications between nurse and on-call physicians attempt to bridge this gap in knowledge.