***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Alphanumeric paging systems are unidirectional without prioritization capabilities . Newer electronic communication devices such as two-way text paging systems are capable of bidirectional paging and prioritization . While previous studies have evaluated alphanumeric paging systems in academic hospital setting s , bidirectional two-way text paging systems have not been investigated . The goal of this study was to evaluate efficiency and impact on patient care delivery of a two-way text paging system compared to conventional one-way alphanumeric pagers . This unmasked , crossover prospect i ve study was divided into three phases . In phase one , surveys were distributed to all ophthalmology attending physicians , residents , clinical technicians , and secretaries to assess the conventional alphanumeric paging system . In phase two , these participants used two-way text pagers without instruction ( unstructured format ) that they subsequently compared to the alphanumeric system with devised surveys assessing ( on a scale of 0 to 100 ) time saved , increased daily efficiency , facilitation in patient care , and overall impression (helpfulness).In phase three , participants used a specific communication prioritization protocol ( structured format ) with the two-way text pagers with subsequent comparison and assessment with the same surveys . Compared to traditional alphanumeric pagers , new digital two-way text pagers were found to be statistically ( p < 0.0001 ) more helpful by participants in all categories : as a time saver ( 80.33 vs. 56.95 ) p < 0.0001 , increased daily efficiency ( 78.15 vs. 57.13 ) p < 0.0001 , facilitation in patient care ( 78.79 vs. 56.95 ) p < 0.0001 , and overall impression ( helpfulness ) ( 61.82 vs. 84.33 ) p < 0.0001 . When compared to the alphanumeric pager , the two-way text pager was found to decrease subjectively call backs ( 73.6 % to 45.6 % , p < 0.0001 ) , reduce interruptions of learning activities ( 43.63 % to 26.6 % , p < 0.0001 ) and enabled better patient care ( 59.8 % to 42.2 % , p < 0.0001 ) . No significant statistical difference was found between the structured and unstructured system . Two-way text paging ( structured versus unstructured guidance ) was preferred over the conventional one-way alphanumeric paging system in every participant category . Two-way text paging is an effective alternative to alphanumeric paging , demonstrating saved time , increased daily efficiency , reduced call backs and interruptions of educational activities , and facilitation in patient care Background : Research into adverse events ( AEs ) has highlighted the need to improve patient safety . AEs are unintended injuries or complications result ing in death , disability or prolonged hospital stay that arise from health care management . We estimated the incidence of AEs among patients in Canadian acute care hospitals . Methods : We r and omly selected 1 teaching , 1 large community and 2 small community hospitals in each of 5 provinces ( British Columbia , Alberta , Ontario , Quebec and Nova Scotia ) and review ed a r and om sample of charts for nonpsychiatric , nonobstetric adult patients in each hospital for the fiscal year 2000 .  Trained review ers screened all eligible charts , and physicians review ed the positively screened charts to identify AEs and determine their preventability . Results : At least 1 screening criterion was identified in 1527 ( 40.8 % ) of 3745 charts . The physician review ers identified AEs in 255 of the charts . After adjustment for the sampling strategy , the AE rate was 7.5 per 100 hospital admissions ( 95 % confidence interval [ CI ] 5.7– 9.3 ) . Among the patients with AEs , events judged to be preventable occurred in 36.9 % ( 95 % CI 32.0%–41.8 % ) and death in 20.8 % ( 95 % CI 7.8%–33.8 % ) . Physician review ers estimated that 1521 additional hospital days were associated with AEs . Although men and women experienced equal rates of AEs , patients who had AEs were significantly older than those who did not ( mean age [ and st and ard deviation ] 64.9 [ 16.7 ] v. 62.0 [ 18.4 ] years ; p = 0.016 ) . Interpretation : The overall incidence rate of AEs of 7.5 % in our study suggests that , of the almost 2.5 million annual hospital admissions in Canada similar to the type studied , about 185 000 are associated with an AE and close to 70 000 of these are potentially preventable Background Interdisciplinary communication is critically important to provide safe and effective care , yet it has been inadequately studied for hospitalised medical patients . Our objective was to characterise nurse – physician communication and their agreement on patients ' plan of care . Methods During a one-month period , r and omly selected hospitalised patients , their nurses and their physicians were interviewed . Nurses and physicians were asked to identify one another , whether communication had occurred , and about six aspects of the plan of care . Two internists rated nurse – physician agreement on aspects of the plan of care as none , partial or complete agreement . Measures included the percentage of nurses and physicians able to identify one another and reporting communication and the percentage of nurse – physician pairs in agreement on aspects of the plan of care . Results 310 ( 91 % ) and 301 ( 88 % ) of 342 eligible nurses and physicians completed interviews . Nurses correctly identified patients ' physicians 71 % of the time and reported communicating with them 50 % of the time . Physicians correctly identified the patients ' nurses 36 % of the time and reported communicating with them 62 % of the time . Physicians and nurses showed no agreement on aspects of the plan of care ranging from 11 % for planned procedures to 42 % for medication changes . Conclusions Nurses and physicians did not reliably communicate with one another and were often not in agreement on the plan of care for hospitalised medical patients BACKGROUND Cellular phone use within the hospital setting has increased as physicians , nurses , and ancillary staff incorporate wireless technologies in improving efficiencies , cost , and maintaining patient safety and high quality healthcare [ 11 ] . Through the use of wireless , cellular communication , an overall improvement in communication accuracy and efficiency between intraoperative orthopaedic surgeons and floor nurses may be achieved . METHODS Both communication types occurred while the surgeon was scrubbed in the operating room ( OR ) . Indirect communication occurred when the pager call was answered by the OR circulating nurse with communication between the surgeon , circulating nurse , and floor nurse . Direct communication consisted of cell phone and Jabra Bluetooth BT200 wireless ear piece used by the surgeon . The surgeon answered the floor nurse 's cellular call by phone ring-activated automatic answering . The study was conducted during scheduled orthopaedic procedures . An independent observer measured time variables with a stop-watch while orthopaedic nurses r and omly called via pager or cell phone . The nurses asked for patient caregiver confirmation and answers to 30 different patient-care questions . RESULTS Sixty trials were performed with 30 cell and 30 page communications . Direct cellular communication showed a better response rate than indirect page ( Cell 100 % , Page 73 % ) . Indirect page communication allowed a 27 % and 33 % error rate with patient problem and surgeon solution communications , respectively . There were no reported communication errors while using direct wireless , cellular communication . When compared to page communications , cellular communications showed statistically significant improvements in mean time intervals in response time ( Cell = 11s , Page = 211s ) , correct patient identification ( Cell = 5s , Page = 172s ) , patient problem and solution time ( Cell = 13s , Page = 189s ) , and total communication time ( Cell = 32s , Page = 250s ) ( s = seconds , all P < 0.001 ) . Floor nurse satisfaction ratings ( dependent on communication times and /or difficulties ) were improved with direct cellular communication ( Cell = 29 excellent , Page = 11 excellent ) . Intraoperative case interruptions ( defined as delaying surgical progress ) were more frequent with indirect page communication ( 10 page v. 0 cell ) . CONCLUSION AND SIGNIFICANCE Our study demonstrates that direct wireless communication may be used to improve intraoperative communication and enhance patient safety . Direct wireless , cellular intraoperative communication improves communication times , communication accuracy , communication satisfaction , and minimizes intraoperative case interruption . As a result of this study , we hope to maintain our transition to direct wireless , cellular intraoperative orthopaedic communication to reduce medical errors , improve patient care , and enhance both orthopaedic surgeon and nursing efficiencies OBJECTIVE To determine the content and urgency of pages and their effect on the activities of pediatric residents . DESIGN Prospect i ve survey . SETTING University-affiliated teaching hospital . PARTICIPANTS Seventeen pediatric residents on regular pediatric services . INTERVENTIONS None . MEASUREMENTS /MAIN RESULTS On daily logs , interns recorded the activity interrupted by a page and rated the urgency and importance of the page . Almost half of all pages interrupted patient care activities , and 24 % interrupted scheduled work rounds or teaching conferences . Interns reported that 34 % of pages result ed in a change in patient treatment , but they rated 25 % of all pages as unimportant . CONCLUSIONS " Beepers " frequently interrupt pediatric residents involved in patient care activities and scheduled educational conferences . Studies of interventions aim ed at decreasing unnecessary interruptions by pages are needed 
    Output:
    
Qualitative studies described improvements in efficiency of communication but also issues of loss of control and reliability .
CONCLUSIONS Despite the rapid advancement in information and communications technology over the last decade , there is limited evidence suggesting improvements in the ability of health professionals to communicate effectively .