Dance of the Call Bells

Abstract

Ethnographic methods can provide insights into patients' perceptions of quality of care. We used ethnographic methods to examine problems related to answering patient call lights on one inpatient unit in the hospital. Communication through call bells consisted of 3 interrelated components. These included answering the call bell, communicating the patient's request, and following through with the request. Results of this study provided a deeper understanding of the nuances of power and control embedded within the issue of patient-caregiver communication and empowered unit staff to find solutions to the call bell problem.

Perspectives of Nurses and Patients on Call Light Technology

“…1 Current literature regarding call light communication presents discordance between patient perceptions and staff expectations for care responsibilities. 3 In accordance with the Institute of Medicine 12 suggestion for the development of innovative health technologies such as call light systems in collaboration with nurses, this study evaluated an alpha-prototype of Eloquence™ from a nurse and patient perspective.…”

“…Usability of the nurse call system for patients, specifically the bedside device, however, is very important as the bedside device (a tablet for Eloquence™) allows patients to initiate the nurse-patient interaction and is key to their perception of feeling safe and having control of getting their needs met. 1,2 Parallel to the usability of the device, both nurses and patients commented on the potential improvement of communication via the Eloquence™ prototype.…”

“…2 Second, nurses and other healthcare staff could arrive to patient rooms prepared to address their patient needs. The perceived improvement on delineating specific nursing personnel to specific call requests could abate previous concerns on the ambiguity on whose responsibility it is to answer the call light 3 and the patient dissatisfaction from responsiveness to call lights 1, 4-6 . Asking patients about their concerns regarding hospital technology is important in the provision of both the delivery of patient-centered care and ensuring the technology meets the end users' needs both in design and functionality.…”

“…Only recently were studies undertaken to demonstrate how this technology affects patient care. Using ethnographic methods, Deitrick et al 1 revealed concerns regarding call light use and found that staff were unclear on whose job it was to answer the call light with some staff members viewing call lights as an interruption to their work flow and delivery of patient care. Patients' comments revealed issues concerning long wait times in getting their calls answered, inconsistencies with the response time, lack of follow through with requests, and differing lengths of time to fulfill their requests.…”

“…These findings are concerning given that call light use is important in providing patient-centered care and it is one way patients can exercise control over their care. 1,2 …”