Mobile phones for doctors have changed the clinical routine tremendously. The pager is gone and everybody can be reached whenever he is at work. Is this a progress? I am not sure.
Turns out that the threshold to contact doctors in semi-important issues is close to an all-time-low while the number of calls and hence interruptions is close to a peak. A ringing phone creates urgency. It could be an emergency. A patient in cardiac arrest, a major bleeding?
Keeping these possibilities in mind, a ringing phone is always more urgent than taking a thorough history, even if your colleague only wants to know whether you wanna order Chinese or pizza.
1. No smalltalk / no greetings on the phone.
2. Batch phone calls.
If you share patients with another doctor it is better to meet once a day or reserve a time slot for phone calls that are non urgent. Create meetings were you talk through your patients. That is way more efficient than ten phone calls.
3. Analyze your phone calls for one day:
- What were the issues you were supposed to solve?
- Were these mostly medical issues that required a doctor to solve the problem or were these issues of organizational nature?
- Which of these issues could be delegated to staff other than doctors?
- Which of these were real emergencies that required fast actions?
- Which of these really calls really saved time?
- Who did you mostly talk to?
- Would it be more efficient to create a once daily meeting?
4. Switch it off or divert your phone.
It is unbelievably rude to talk on the phone while others are speaking about patients and delivering important information. Somehow we have gotten used to it. But it is not only rude toward the one who’s talking but also rude toward the patient, who is talked about.
The only exception during handover should be one emergency phone that is answered with the words: “Is this a medical emergency? Can you call back in ten minutes?”
One doctor should be put in charge of this job that only has the goal to protect the handover from nonsense interruptions.
I am not against phones in the hospital. I think they serve a clear purpose. It’s just the way we use them destroys our clinical workflow and ultimately harms the patient.