Supplemental 3: Paging and Vocera Standard Work
Work Performed By / Major Step / Details / Comments
1 / Nurse or MSA / Identify the need to page a Physician /
  • Use Stanford Smart Paging System to Text Page a Physician:
  • Identify Team and PAGE IDby checking ADT order (under orders tab) in CPRS.
  • For Direct Admits who do not yet have and ADT order: page the admitting team ghost pager: Number 27113
/
  • This will ensure you have the correct team.
  • Please do not use the phone to page or numeric page.
  • Please use the page ID (ghost pager) as first line, not the individual’s name.

2 / Nurse or MSA / Information to be included in the text page /
  • Patient’s first initial of last name and last 4 (as per privacy officer)
  • The problem you need addressed for the patient.
  • Include unit, call back number and the nurse’s name
/
  • To inform the physician of the patient, problem, unit to call, and who they need to speak with.

3 / Nurse or MSA / Prioritization of paging /
  • All pages must include either “FYI” or “please call back.”
  • “FYI”: Use to inform physician regarding your patient and does not require a call back.
Ex: FYI M1234- PVR bladder scan is 150. 2C, ext. 68217 Mary, RN
  • “Please call back”: Use to request a call back within 15 minutes.
Ex: Please call back- Family of M1234 would like to discussMRI results. 2C, ext 68217. Mary, RN
Ex: M1234 is scheduled for a procedure, BS is 90. Do you want me to hold the insulin?IICU, ext 62200. Mary, RN Please call back.
  • “ASAP”: For urgent issues requiring follow-up within 5 minutes: Vocera the intern. “Urgently Call Team A intern 1” Use ONLY for urgent issues.
Ex: M1234 continues to complain of 10/10 pain. All PRN meds given and not effective. Please call back ASAP. 2A, ext 64565. Mary, RN
Note: Please do not replace ASAP page or Vocera when an E-team is needed. /
  • To inform the physician of the patient, problem, unit to call, and who they need to speak with.
  • To create a standard communication and call back responses from physicians, please use the “FYI, Please call back, “STAT/ASAP” only.

4 / Medicine housestaff / Response to page /
  • FYI page: no call back required. Address the information as deemed appropriate (ex. Entering a medication order or nursing text order)
  • Please call back: call back or go to bedside within 15 minutes
  • Urgent vocera call: establish plan with nurse or go to bedside within 5 minutes
/
  • If housestaff is unable to return page in a timely manner, s/he should ask for help from other intern/res/attn. on the team

5 / Nurse or MSA / Physician Paging Escalation Pathway /
  • If no return call in the allotted time as defined in #3, use the following physician paging escalation pathway:
From 7am-7pm:
Vocera “Call Team A intern 1” (found in ADT orders)
Page Resident (found under ADT order in CPRS)or Vocera “Call Team A Resident”
Page Attending (found under ADT order in CPRS)or Vocera “Call Team A attending”
From 7pm-7am:
Page ID (ghost pager) 2nd time
Call night team landline: #66515
Vocera nocturnist attg. “Call nocturnist” or page 11800.
  • To page resident or attending: enter that person’s name in smartpage
  • To Vocera: say their positon (example:Team A attending”)
Note: Please use your nursing judgement in determining when to use the physician paging escalation pathway. If unsure, please discuss with the charge nurse or nurse managers for direction. /
  • To meet the needs of the patient when no response to 1st page to page ID (ghost pager).
  • Housestaff may not return page for a variety of reasons—some pages are not transmitted, pager not forwarded correctly, busy with other patient care, etc.

VA Palo Alto Health Care SystemJune2016