AST Guideline - Use of Mobile Information Technology in the Operating Room

11 Guideline V OR personnel should use email and smartphones in an efficient and professional manner to coordinate the effective care of surgical patients. 1. Studies have identified both positive and negative outcomes with the use of smartphones between physicians, allied health professionals and nurses. A. There is a perceived improvement in the efficiency of using smartphones and email over the use of pagers. 40,52 1) Allied health professionals and nurses found that when faced with an urgent patient care issue being able to directly call a resident or physician eliminated the need to wait for a telephone call reply to the page, which also decreased the occurrence of “phone tag”. 53 2) Equally, non-urgent issues can be efficiently communicated by allied health professionals and nurses through the use of email to prevent disrupting the resident or physician. 54,55 B. Results of studies have identified professional issues associated with the use of smartphones that healthcare personnel (HCP) should immediately resolve to achieve a positive outcome for the patient. 1) Interviews with staff physicians and residents identified a perceived increase in the number of calls and messages received causing interruptions in patient care and teaching. 56,57 Physicians have observed these interruptions could have negative impacts on the communication and interaction with patients including adverse events. 53 2) There is a “gap in perceived urgency” meaning what the allied health professional or nurse considers an urgent patient issue as opposed to the physician or resident not considering urgent, thus not responding or delaying a response to the email or smartphone message. 53,55,58 Rather than allowing the issue to become a significant barrier to providing quality patient care, the healthcare team should address the issues including establishing parameters as to when and how physicians and residents should be contacted, e.g. abnormal vital signs in preoperative holding or PACU, abnormal bleeding in PACU. 3) All HCP, including physicians, residents, allied health professionals, and nurses, should be aware of instances when interrupting conversations or professional rounds by answering a smartphone or email message could be regarded as disruptive, especially when discussing the details of a patient, and unprofessional. 59,60,61 Additionally, this behavior could be a source for creating a negative perception among patients and if they are receiving the full attention of the HCP. 54