questions

Voalte System

Transition from Unidirectional to Bidirectional Text Paging System with Use of Voalte System

The Voalte system has been in place as a text

paging system since it was purchased by Hill-

Rom in 2018. It’s highly affective and reliable for

communication. It offers real-time tracking,

phone calls, and text messages all within

compliance of HIPAA.

Why is this an issue?

- Unidirectional paging systems lack standardization and

do not indicate level of urgency. Communication

errors are the most common cause of preventable errors

related to critical labs, patients, and how long it takes for

providers to assess the patients in a timely manner.  

- The Joint Commission currently identifies

communication failure as one of the most common causes

of sentinel events. 

815 Infographic

Dallas Foley

Transition to secure text messaging system as a bidirectional method of communication within the acute care setting, in comparison to unidirectional traditional paging systems to improve nursing and staff satisfaction and patient outcomes, resulting in a decrease in patient delay of care.

In review of over 14,000 hospital admissions,

communication problems were found to be the

most common cause of preventable errors. 

It is not routine to address the paging

systems on an annual basis. Little to no

feedback is acquired from

administrative personnel. The goal of

this intervention is to improve

satisfaction with caregivers on all levels

with a specific mean of communication

AND to improve patient care and

outcome.

Risk-averse

Quality Improvement

Approach to risk

PICO-T

In a breakdown of malpractice issues in the

Emergency Department, 12% of cases were due

to communication errors and 9% were related to

delay of care. 

P: Survey - Ideas regarding what current changes caregivers in

the acute care setting would like to see regarding change.

What is the current favored method of communication? Have

they experienced any sentinel events d/t lack of

communication?

D: Test the theory for areas of improvement (Cycle 2). Educate

staff members about opportunities for improvement. 

S: Direct observation of nursing staff within ICU.

A: Follow one nurse, one provider, and one patient during shift.

Observe and take notice of communication methods and time

it takes for response. 

1PDSA Cycle

2PDSA Cycle P:  Does a bidirectional secure messaging system help to prevent and reduce the number of communication errors?

Discuss with 3 RNs, 2 MDs, 1 RT, 1 PCA

D: 3/3 RNs, 1/2 MDs, 1/1 RT, and 1/1 PCA were open to the

idea. There was hesitancy related to resistance to change. 

S: Informational documents to include purpose, statistics, and

pictures were helpful to staff members. 

A:  Open the discussion to more staff members within the ICU. 

Gather baseline data from

nurses, techs, providers, midlevel

providers, therapists regarding

current satisfaction in paging

system

Educate.

Disperse informational

documents to ICU staff.

Create a new streamlined

bidirectional communication

route.

3PDSA Cycle Discuss statistics related to the

change. Openly discuss barriers

to care related to lack of

communication.

P:  Separately interview RNs and MDs. Ex. Do you feel that you

could better serve your patients if you were able to

communicate via secure text messaging?

D: Run the test/survey different nurses related to opinions of

communication errors present that have previously negatively

affected patients. 

S: Out of all interview questions, it was evident that a change

related to the current paging system needed to occur.

A:  Next step is to open discussion up to other ICUs. A >70%

satisfaction score would indicate necessary change. 

Source   |   Diffen

Summary

- After conducting an initial cost to benefit analysis, it was proven

that the transition to a bidirectional paging system was the best

option. 

-  In a small 3-cycle study within a single ICU, there was a >70%

satisfaction score related to staff members believing that a change

was necessary and the transition would be successful in decreasing

communication errors. 

References

Hill-Rom. (2021). Empowering your caregivers with mobile communications. Voalte mobile

solution. https://www.hillrom.com/content/dam/hillrom- aem/us/en/marketing/products/voalte-platform/documents/APR154702-EN- r2_Voalte-Mobile-Overview_Presentation_LR.pdf

 Hansen, J.E., Lazow, M., Hagedorn, P.A. (2018) Reducing interdisciplinary communication

failures through secure text messaging: A quality improvement project. http://doi. 10.1097/pq9.0000000000000053