SHM Converge Scientific Abstract ePoster Gallery-Hospitalist and Nurse Concordance of Assigning Priority Classification to Pages

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This study examined how bedside nurses and hospitalists assign priority labels to pages at a large urban medical center. The hospital used an optional tiered paging system with three labels: “911” for urgent action required, “ACTION” for non-urgent action required, and “FYI” for informational messages.<br /><br />Over a 5-week period, 7,211 pages were sent from nurses to direct care hospitalists. Most pages included a priority label: 53.1% were “ACTION,” 37.6% were “FYI,” 0.3% were “911,” and 9.0% were unlabeled. A convenience sample of 250 masked pages was independently reviewed by two hospitalists, with a third senior hospitalist resolving disagreements.<br /><br />Key findings:<br />- Nurses used the labeling system frequently, with 91% of messages tagged.<br />- A substantial share of pages were informational and non-urgent: 38% were “FYI.”<br />- Hospitalist reviewers showed moderate agreement with the nurses’ original labels overall (Cohen’s kappa 0.52).<br />- Interrater reliability between the two hospitalists was strong (Cohen’s kappa 0.80).<br />- Hospitalists tended to classify more messages as requiring action.<br />- Concordance was weakest for pages labeled “911,” suggesting different interpretations of what counts as urgent.<br /><br />The authors concluded that there is room to improve alignment between nurse and hospitalist understanding of page urgency. Better agreement could improve communication and make paging easier to triage. Limitations included the single-center design, a small reviewed sample, and hospitalists being blinded to clinical context.

Asset Subtitle

Sarah J. Flynn

Meta Tag

Author List Esther Y. Hsiang, Molly A. Kantor, Raman R. Khanna, Sarah J. Flynn

Category Research

Concept Paging Priority Labeling System

Concept Priority Label

Concept Urgency

Concept Page

Concept Agreement

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Department of Medicine, University of California San Francisco

Presenting Author Sarah J. Flynn

Track Communication

Keywords

bedside nurses

hospitalists

paging system

priority labels

urgent communication

Cohen's kappa

interrater reliability

page triage

hospital communication

single-center study

Paging Priority Labeling System

Priority Label

Urgency

Page

Agreement