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CRITICAL CARE AND TRAUMA

Communication in Critical Care Environments: Mobile Telephones Improve Patient Care

Roy G. Soto, MD^*, Larry F. Chu, MD, MS, Julian M. Goldman, MD, Ira J. Rampil, MD, and Keith J. Ruskin, MD^¶

*Department of Anesthesiology and Department of Anesthesiology and Neurological Surgery, University at Stony Brook, Stony Brook, New York; Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, California; Department of Anesthesia and Critical Care, Harvard Medical School, Boston, Massachusetts; ¶Departments of Anesthesiology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut

Address correspondence and reprint requests to Roy G. Soto, MD, Stony Brook University, Department of Anesthesiology, Stony Brook, NY 11794. Address e-mail to roy.soto{at}stonybrook.edu.

Most hospital policies prohibiting the use of wireless devices cite reports of disruption of medical equipment by cellular telephones. There have been no studies to determine whether mobile telephones may have a beneficial impact on safety. At the 2003 meeting of the American Society of Anesthesiologists 7878 surveys were distributed to attendees. The five-question survey polled anesthesiologists regarding modes of communication used in the operating room/intensive care unit and experience with communications delays and medical errors. Survey reliability was verified using test-retest analysis and proportion agreement in a convenience sample of 17 anesthesiologists. Four-thousand-eighteen responses were received. The test-retest reliability of the survey instrument was excellent (Kappa = 0.75; 95% confidence interval, 0.56–0.94). Sixty-five percent of surveyed anesthesiologists reported using pagers as their primary mode of communications, whereas only 17% used cellular telephones. Forty-five percent of respondents who use pagers reported delays in communications compared with 31% of cellular telephone users. Cellular telephone use by anesthesiologists is associated with a reduction in the risk of medical error or injury resulting from communication delay (relative risk = 0.78; 95% confidence interval, 0.6234–0.9649). The small risks of electromagnetic interference between mobile telephones and medical devices should be weighed against the potential benefits of improved communication.

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