For example, if a patient’s cardiac monitor detects a dangerous arrhythmia, that information is sent to the unit’s “command center,” where a cardiac nurse sends out a red alert via text message to that patient’s nurse and the charge nurse. A beep or vibration from the nurse’s BlackBerry indicates that a new text message has arrived. The nurse can glance at the device, see that the alert is red, and reply immediately, eliminating several problems with overhead paging systems: the need for repeated pages, the inability of the nurse to respond, excessive noise on the unit, and delays in response.

The 30-bed unit employs nine registered nurses (RNs) on the day shift and nine on the night shift and has been testing a variety of devices for more than 2 years. Staff were involved from the beginning, Ms. Pileggi said, and everyone, including aides, received training from Emergin.

An Investment in Safety. Use of the BlackBerry devices has cut the number of overhead pages on the unit by more than half. Nurses report less alarm fatigue and faster response times to alarms, and they receive critical laboratory values 10 minutes sooner under the new system than under the old one. They also save time by not handling alarms that do not require a nurse’s attention.

Darren Dworkin, chief information officer for Cedars-Sinai, said the initial costs of purchasing the devices and training the staff have paid off in more efficient and safer care. “Enabling nurses to spend more time at the bedside is a goal we want to achieve,” he said, “and so if the technology achieves that, then we are achieving our return on investment.” The unit has not conducted a cost–benefit analysis.

Los Angeles hospital Cedars-Sinai is a leader in using mobile devices for text message patient alerts and notifications.

Los Angeles hospital Cedars-Sinai is a leader in using mobile devices for text message patient alerts and notifications.

Few manufacturers are designing technologies with nurses in mind, and limitations of the available technology have meant that not all ideas for improving processes can be tested. For example, the unit could not incorporate IV pump alarms into the most recent test. Still, bedside nurses and patients are quite pleased. The nurses are looking forward to a test of iPhones, which will display cardiac rhythms on screen. Said Ms. Pileggi, “We’re anticipating patients’ needs, so there hasn’t been the need for patients to call as often.”



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