Wi-Fi - getting our communication beyond the 1980’s
This week my Tuesday surgeon and I did a major cancer resection as usual. Our service has recently moved to another hospital within our NHS trust whose proximity to Wormwood Scrubs prison means that the phone reception and 4G coverage in the hospital is absolutely terrible, with enormous black spots, emails stuck in the outbox, “failure to send” text messages and general isolation from modern humanity. (I’m being dramatic, I know, but bear with me).
As usual, my surgeon popped to the office while I was anaesthetising the patient, which takes a bit of time – thoracic epidural, double lumen endotracheal tube, cannulas, nasogastric tube, subclavian central venous line and an arterial line. As usual, after about 40 minutes I sent him a ‘5 minute warning’ text message, and then the patient was ready for our time-out safety check and an all-day operation.
However, there was no sign of Mr Tuesday, or his trainee. I was a little puzzled as they’re pretty reliable, then looked at my phone. The text message hadn’t gone through. Our hospital provides a very slow free wifi that throws you off it the minute you give up waiting for a page to load, with an option of paying £25 or so per month for a faster, more reliable version, that still logs you off when you’re not looking. The message had the lovely red circle by it after my phone gave up trying to send it. I tried ringing him but couldn’t get reception. The wifi wasn’t strong enough to do an internet call, and in any case his phone was logged off from the modern world and receiving nothing. We ended up going for the 1980’s approach and one of the scrub staff went to find him, which he did. All went well, we lost about ten minutes of operating time (at a cost of about £120, but who’s counting…) and then went on to operate for the rest of the day.
In the same way as most of the population is addicted to their smartphone, we rely on our phones for communicating with each other at work. This incident spurred me to ask the twitter hive mind how common this is, and whether it affects the way we work.
Although not scientific and biased to my followers I think the results are probably quite representative (or maybe under-representative of the places with no wifi and poor phone reception as they’re less likely to have seen the poll). 1144 people responded to the first poll, with 12% reporting no wifi access at all, 58% with a slow free wifi, and only 27% with good wifi access.
This means there are many, many hospitals in the UK where connection to the internet is at best intermittent, and some where it is completely absent. So what? So – we access a lot of medical information and decision support on the internet, most of our professional communication is via instant messaging. I did a night shift as a trainee last Friday night, and the team comms were much enhanced by our instant messaging group, leading to a safer and more efficient service. Finally, as I have previously discussed on this blog, WhatsApp was an absolutely brilliant tool for communication during our major incidents in 2017. (see https://traumagasdoc.wordpress.com/2017/07/23/whatsapp-doc/)
This is not acceptable. Having a slow log-on Wi-Fi for hospital staff, where your phone is logged out into the black hole as soon as you stop looking at it is no way of enhancing the way we communicate and is detrimental to both the efficiency and safety of the service. This is particularly true for times when the service is stretched or when urgent communication is necessary. Having no Wi-Fi at all is inexcusable.
Getting the NHS technology out of the 1980’s is one of the priorities for the NHS long term plan, and the health secretary has made it one of his personal priorities to improve the IT infrastructure of hospitals. This is happening in many places (our health records are electronic, and most of us really like it), but we need to get the basics right.
Providing a reliable always-on staff Wi-Fi should be as basic to a hospital’s function as providing hot water or piped oxygen. In today’s world it is no longer a luxury, but an essential piece of infrastructure required for effective and safe communication within hospitals.