Impact of a Hands-free Wireless Communication Device on Communication and Clinical Outcomes in a Pediatric Intensive Care

INTRODUCTION: Timely communication is essential in the intensive care environment. Delays may occur if communication relies on identification of individuals through line of sight, or use of telephones and pagers. We measured communication delays, staff perceptions, and clinical outcomes before and after implementation of a hands-free wireless communication device (HWCD) in a pediatric intensive care unit (PICU). METHODS: Single-center study comprising 3 components: observational study of verbal communication among PICU staff; staff survey regarding perceptions of communication delays; analysis of clinical data (length of stay, risk adjusted mortality, emergency events). All components were conducted before and after implementation of the HWCD. RESULTS: Four hundred sixteen hours of staff working time were observed (210 pre- and 206 postimplementation). These data showed significant reduction in communication delays—most notably among roaming staff [median time to response to verbal queries before and after implementation 120 seconds (interquartile range, 6–255) and 9 seconds (interquartile range, 7–30), respectively: P < 0.001]. The results of the staff survey showed significant improvements in staff perceptions of communication delays in all roaming staff groups utilizing the HWCD. The survey response rate was 205/361: 56.8%. There were no differences in clinical outcomes from the routinely collected clinical data. There was a significant reduction in emergency event rate—emergency summoning of assistance to bedside (per 100 bed-days)—before and after implementation, 2.17 and 1.69, respectively: rate ratio = 0.78 (95% confidence interval, 0.63–0.95; P < 0.05). CONCLUSIONS: Implementation of a HWCD was associated with significant reduction in communication delays among roaming staff members in PICU.