SHM Converge Scientific Abstract ePoster Gallery-Just Let Me Work: A Hospitalist-Led Initiative to Reduce Low-Value Nighttime Pages and Enhance Care

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This hospitalist-led quality improvement project at Harbor-UCLA Medical Center aimed to reduce low-value nighttime pages, which are often nonurgent interruptions such as routine status updates, minor lab issues, comfort-medication requests, and other issues that can wait until morning. The team noted that unnecessary pages distract from patient care, increase burnout, and strain physician-nurse collaboration.<br /><br />Using Plan-Do-Study-Act (PDSA) cycles from November 2023 through November 2024, the team tracked nighttime pages, admissions, and census in Excel and reviewed trends monthly with control charts. After refining data collection and establishing baseline performance, they implemented two main interventions: first, a standardized order set that included modified vital sign notification parameters and preselected PRN medications for pain, nausea, and sleep; second, collaboration between hospitalist leaders and unit nursing leadership to defer clearly nonurgent pages such as restraint renewals, isolation-status updates, and documentation of central line or urinary catheter necessity until morning.<br /><br />The project found that pages per night decreased from a pre-intervention mean of 46.9 to 39.8 post-intervention, a 15% reduction, with statistical significance (p = 0.01). The control chart also showed a downward shift after the interventions, though later regression toward the mean occurred.<br /><br />The authors conclude that even a simple, hospitalist-directed data collection and improvement process can reduce nighttime pages. They emphasize that focusing on controllable workflow elements and improving nurse-hospitalist communication can empower hospitalists as agents of change while improving the nighttime work environment.

Asset Subtitle

Huy Do

Meta Tag

Author List Andrew Young, Esther Joo, Huy Do, Jessica Lo

Category Research

Concept Nonurgent Nighttime Pages

Concept Quality Improvement

Concept PDSA Cycle

Concept Nighttime Page Reduction

Concept Order Set

Distinguished Non-Finalist

Presenter Organization Harbor UCLA Medical Center

Presenting Author Huy Do

Track Quality Improvement

Keywords

hospitalist

quality improvement

nighttime pages

PDSA cycle

Harbor-UCLA Medical Center

low-value interruptions

nurse-hospitalist communication

control charts

order set

burnout reduction

Nonurgent Nighttime Pages

Quality Improvement

PDSA Cycle

Nighttime Page Reduction

Order Set