Patterns of Paging Activity Among Oral and Maxillofacial Surgery Residents: Implications for Patient Care

Anthony J Burgois; Christopher M Edwards; Thomas Austin; Shelly Abramowicz

doi:10.1016/j.joms.2024.10.013

Patterns of Paging Activity Among Oral and Maxillofacial Surgery Residents: Implications for Patient Care

J Oral Maxillofac Surg. 2024 Oct 28:S0278-2391(24)00909-1. doi: 10.1016/j.joms.2024.10.013. Online ahead of print.

Authors

Anthony J Burgois¹, Christopher M Edwards², Thomas Austin³, Shelly Abramowicz⁴

Affiliations

¹ Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: aburgoi@emory.edu.
² Assistant Professor of Anesthesiology, University of Florida.
³ Professor of Anesthesiology, University of Arkansas for Medical Sciences.
⁴ Professor and Director of Research, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine; Section Chief, Pediatric Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta.

PMID: 39549724
DOI: 10.1016/j.joms.2024.10.013

Abstract

Background: One-way alphanumeric pagers remain a primary communication method for health care providers, despite the rise of app-based communication systems. Frequent nonurgent pages can disrupt workflows and potentially impact patient care, particularly in high-demand specialties like Oral and Maxillofacial Surgery (OMS).

Purpose: The purpose of this study was to examine the association between paging patterns and time of day among OMS residents.

Study design, setting, sample: This retrospective cohort study analyzed paging data from the Emory Healthcare OMS service in 2021 and 2022. Pages included were those received by primary OMS residents responsible for inpatient care, consultations, and emergency department evaluations. Exclusions were pages related to outpatient matters and those sent to backup or senior-level residents.

Predictor variable: The primary predictor variable was paging rate, defined as the number of pages received per hour. This measure captures the intensity of paging activity during specific periods.

Main outcome variable: The primary outcome variable was time of day, categorized into peak and off-peak hours. Peak hours were statistically determined through data analysis and were defined as 07:00-20:00 on weekdays and 09:00-14:00 on weekends. Off-peak hours included all other time periods. Secondary outcomes included the comparison of paging rates on weekdays versus weekends to identify potential variations in paging activity.

Covariates: There are no covariates.

Results: There were 7,224 pages. Of them, 4,626 pages met the inclusion criteria. In 2021, there was an average of 18.8 pages per day (range: 0 to 56; SD: 10.2). In 2022, there were 19.2 pages per day (range: 3 to 52; SD: 8.7). Weekdays had more pages (20.8 pages/day) than weekends (14.3 pages/day; P < .001). During weekday peak hours, there were 1.3 pages/hour compared to 0.4 pages/hour during off peak hours (P < .001). During weekend peak hours, there were 0.9 pages/hour compared to 0.5 pages/hour during off-peak hours (P value < .001). Weekdays between 0700 and 0800 had the highest average number of pages (1.53 pages/hour).

Conclusion and relevance: This study identified patterns in paging rates, with significantly higher paging activity during peak hours and on weekdays. Awareness of these patterns may inform the development of protocols to minimize nonurgent interruptions during critical times, such as during patient handoffs.