S2999 Changes to Electronic Paging System Improve Overnight Paging Efficiency for Gastroenterology Fellows

Introduction: Each year, approximately 15 million emergency room visits in the U.S. are related to gastrointestinal (GI) diseases, ranging from mild to life-threatening. Gastroenterologists often take overnight home call, providing after-hours consultation while off-site. This model, though efficient, contributes to sleep deprivation, burnout, and reduced wellness. Meanwhile, communication has evolved beyond traditional alphanumeric pagers to smartphone applications. One tool, PerfectServe®, enables message delivery via text. Given the increasing burden of GI disease, rising volume of pages, and growing concern over physician wellness, improving after-hours message triage is essential to ensure urgent issues receive timely attention while routine concerns are deferred appropriately. Methods: At a tertiary care academic hospital, we implemented 2 interventions within the GI overnight paging workflow (6:00 PM to 7:00 AM) using the PerfectServe® system. (1) A splash screen notification informing paging providers that GI fellows were on home call. (2) A filtering mechanism that allowed routine (non-urgent) messages to be stored overnight and automatically forwarded to the next on-call GI fellow the following morning. Urgent messages continued to be delivered immediately. We collected daily logs of all GI overnight pages for 2.5 months before and after implementation and statistical analyses compared pre- and post-intervention volumes. Results: In the pre-intervention period, 460 total pages were sent (158 routine, 302 urgent), averaging 5.97 pages per night (2.05 routine; 3.92 urgent). Post-intervention, this dropped to 364 total pages (61 routine, 303 urgent), averaging 4.73 pages per night (0.79 routine; 3.93 urgent). Routine pages decreased significantly (P < 0.01), indicating improved triage. Urgent page volume remained unchanged, suggesting maintenance of timely care. Overall nightly page volume also declined significantly. Conclusion: Implementation of a home-call notification and routine page deferral significantly reduced the number of routine overnight pages (2.05 to 0.79 per night) and total overnight page burden (5.97 to 4.73 per night). Importantly, urgent pages remained unchanged, indicating that timely care was preserved. These interventions improved message triage, reduced overnight disruptions, and may contribute to better sleep, reduced burnout, and improved well-being among GI providers. The approach is scalable and can be adopted by other departments with similar call structures.