Mobile devices have become an essential part of healthcare workers lives inside and outside of work. Smart phones have capabilities that allow rapid and immediate access to information for healthcare workers. They have been shown to allow for rapid communication and improved accessibility and responsiveness of staff 6. Studies have shown that most healthcare workers believe smart phones should be integrated within hospital systems.7,8. The delivery of high-quality, safe, and effective healthcare is an intricate task that requires the careful and precise collaboration between numerous healthcare professionals in the care of a single patient.
The hospital switchboard plays a central role in the provision of services in hospital. In addition to linking health professionals to one another, they also connect patients and relatives to their healthcare providers. They coordinate communication during emergencies and critical events and hence play a critical role within the hospital.
A recent audit showed that only 36% of 219 of UK hospitals switchboard met the 20 second target response time [ 9]. Response time is a key goal and measure of efficiency for switchboards . Over-reliance on hospital switchboard personnel uses significant manpower resources and contributes to delays in addressing calls and queries for non-directory related services. The use of hospital switchboard for directory queries may also delay effective communication between healthcare professionals, which may lead to delays in patient care and clinical decision making. Reducing the call burden therefore helps to improve response time, resulting in increased efficiency in communication between healthcare providers.
Our study demonstrates that the implementation of a contact directory app resulted in a statistically significant reduction in the proportion of internal phone calls to the hospital switchboard to request for bleep and hospital extension numbers (p<0.001). The implementation of the contact directory app resulted in a 10.9% (246) reduction in total phone calls to the hospital switchboard. This shifted the workload from the hospital switchboard and resulted in an increased proportion of calls to the switchboard from external lines, and from internal calls requesting to be transferred to external lines. The 24-hour control and testing periods that was studied incorporated a similar timeframe during the working week, however heterogeneity may be difficult to determine due to possible variations in hospital workload during the Covid-19 pandemic setting.
The use of mobile devices in healthcare can lead to improvements in workflow, efficiency, and effective communication. Several studies have demonstrated that the use of smart phones has led to more effective communication by demonstrating improvements in the quality of clinical discussion , improvements in patient care , and faster response times . Another study demonstrated that smartphones generated additional value by enabling a straightforward delivery of nonurgent information while also assisting in the triage, prioritization, and rapid communication in urgent situations in the healthcare setting . The utilisation of smart phones can not only improve the efficiency and effectiveness of communication between healthcare workers, but it can also reduce interruptions in patient care in hospitals . In addition to improved efficiency and quality of communication, mobile devices can also have a positive impact on interprofessional interactions between healthcare workers and improve decision making process as key decision makers are more easily accessible .
Despite the multiple benefits on the use of smart phones in the hospital setting, concerns regarding providing a distraction for healthcare workers and potentially giving healthcare workers an unprofessional appearance in hospitals have been reported . Several other limitations on the use of mobile devices in the healthcare setting have been reported. This includes the poor battery life and unreliable connectivity in the hospital setting which can limit its effectiveness [4,12,13]. A 2019 systematic review on the use of mobile technology in hospital setting showed that the use of mobile technology enhanced communication and teamwork in the hospital setting and its limitations was scarce . Despite some negative reports on the use of mobile devices in the healthcare setting, the systematic review concluded that mobile devices acted to remove barriers for effective communication. In one study 85% of healthcare workers recommended the widespread use of mobile devices  and in another study 92% agreed that there is significant potential for the integration of mobile devices in the hospital setting .
One of the major concerns with using personal mobile devices routinely in healthcare is the potential risk to the confidentiality and security of patients and staff members . Despite this negative consequence of mobile devices, many studies have showed healthcare workers strongly support the use a mobile devices in the healthcare setting and strongly encourage their wider use in hospitals [3,7,8]. This highlights the importance healthcare workers perceive the use of mobile devices for their work in the healthcare system. The contact directory app we implemented contained no personal information of staff, or patients. This smart phone app allows staff members to find the hospital contact extension or bleep number they wish to request without the necessity of have to contact the hospital switchboard to request their desired contact number. This allows healthcare workers to utilise the benefit of the improved effectiveness and efficiency in communication because of the smart phone app, with no risk to their confidentiality and personal security.
The use of smart phones in healthcare may require healthcare organisations to develop policies and guidelines on their use to help guide healthcare workers towards their safe and effective utilisation. Many individual healthcare organisation may not have such policies implemented for their personnel on the use of smart phone routinely in their organisation. National advice on the use of mobile technology in the healthcare setting by the health service executive (HSE) which is the governance body of health services in Ireland is available and they have produced online guidance on the use of mobile technology, and social media in healthcare. They acknowledge that “smart phone use is ubiquitous” and that “social media is currently being used by many HSE departments and staff and for both internal and external communication” . This can help healthcare organisations embrace the “mobile-first” culture within their organisation and provide the required leadership and motivation to implement change in their organising by utilising smart phones to improve efficiency and effective communication while being mindful on the risk of their use in healthcare.
Healthcare workers use innovative technology both inside and outside of work, yet frequently resort to outdated methods to use a directory in the hospital setting to coordinate and deliver care to patients. The requirement for immediate and accurate communication between healthcare workers in the hospital setting, together with the potentially harmful consequences of delayed or inaccurate communication means that modern technology for improving communication must continue to be studied robustly. Our study demonstrates a potential use of mobile technology in the hospital setting and more resources and leadership is required to embrace the current digital age to lead to further innovation and quality improvement.