A Walkie-Talkie Primer
One of the first Coleman principles that a DPI™ Team learns in its process improvement journey is to “Communicate Directly.” Walkie-Talkies, or two-way radios, are one of the easiest and cheapest ways for members of Patient Care Teams (PCT) to stay connected to one another and work efficiently. As a matter of fact, tight PCT communication is impossible without direct and frequent communication.
One of the joys of working in a Patient Centered Medical Home (PCMH) and in a PCT is the ability to convey information rapidly—to update the status of patient flow, to solve a problem, to ask for help. Walkie-Talkies eliminate the frustrating and time-consuming hunt for team members who may be at opposite sides of a closed door or in different corners of the clinic.
We highly recommend Motorola Professional CLS1410. Motorola has a huge chunk of the market and consistently receives high marks from consumer product testing groups. We have also tested COBRA and Midland Walkie-Talkies. They both have their strengths and are reasonably priced; however, we prefer and have the most experience with Motorola.
The current preferred Motorola model that we have upgraded to is the CLS1410. This model is pricey ($135 per Walkie-Talkie plus the ear piece). They come with a cradle for clipping on to your belt or pocket, a charger, and some also include the earpiece. Our team has found that the investment is worthwhile in order to obtain the high quality and durability. Frankly, you would be hard-pressed to find a Chispa (Coleman Associate team member) willing to give up his or her Walkie-Talkie.
Another option that we used for many years is the Motorola Talkabout. This Talkabout costs about $40 for a set of two. It is either rechargeable or can run on batteries (three AAA batteries).
Motorola is forever introducing new models, so don’t get bogged down looking for any particular model, since the model numbers change frequently. Look for Walkie-Talkies that have channels and sub channels. The sub channels split up the wave range of a specific channel, making it much less likely that you will have any interference (static or other folks from the neighborhood on your channel).
Walkie-Talkies have either a digital +/- volume control button or a knob on the top that you turn to lower or raise the sound volume. We like the models with the knob because it adjusts so easily—and you’ll find yourself doing this frequently.
The key to selecting a Walkie-Talkie brand is testing. Make sure that you test the Walkie-Talkie brand in your building with your staff before you buy a bunch of them. Different buildings have different challenges like lead doors, metal interiors, etc., that can strongly interfere with reception. What works for one site may not at all work at another location. And, of course, different staff like different tools. So, before you invest much money in Walkie-Talkies for the whole clinic, test them well, keeping in mind that Walkie-Talkies that work in one clinic may not work in another because needs vary widely.
Where do you buy the darn things? You can find them at local electronics stores or on Amazon.com, where you can also get a variety of accessories for them. Amazon has a good range of headsets for Motorolas, which is important to know, because good headsets are hard to find. Be careful when buying headsets and make sure that you double check what kind of pin you need. There are one and two pin inputs across Walkie-Talkie types, and sometimes they come in different sizes.
Most Patient Care Teams that use Walkie-Talkies also use headsets. Many teams find that having headsets cuts down on ambient noise and allows for staff members from different teams to be in the same space without any cross communication.
When buying headsets, most teams use earbuds or over-the-ear models. You can definitely find headsets that have better sound and a more prominent microphone, but for most teams, the convenience and cost of the over-the-ear models can’t be beat. Motorola makes an over-the-ear model for around $20 a pair.
As with Walkie-Talkies, we recommend that before purchasing large numbers of the headsets, you test them out first. Again, this follows our concepts of iterative testing to ensure effectiveness and practical usability before committing long term to a solution. They have a “fit” that needs to match the ear in order to ensure that discomfort won’t be a barrier to them being worn day after day after day.
Well, now that you’ve bought your Walkie-Talkies, how do you use them for optimal efficiency? Here are some tips, gleaned from the combined experience of DPI™ Teams all over the country:
- After you acquire your Walkie-Talkies, read the manual. It sounds obvious, but it’s amazing how many people never take the time to complete this step! Learning about your Walkie-Talkie from the manual could save you much anguish later.
- Each Patient Care Team will likely want to use its own channel, and each team should use the same channel and sub channel consistently every day. For example, Team A uses channel 3, sub channel 5; Team B uses channel 9, sub channel 22.
- Each team member is responsible for charging his or her own Walkie-Talkie or making sure that it has batteries. If you have Walkie-Talkies that use non-rechargeable batteries, we highly recommend keeping extras handy. Each team member is also responsible for storing his or her own Walkie-Talkie so that it doesn’t walk away!
- At the beginning of every day, the PCT needs to test all Walkie-Talkies and make sure everyone’s on the same channel. Test the volume and make sure your teammates can hear you.
- Pause a moment (about one second) while holding down the talk button before speaking to allow the Walkie-Talkie to engage—otherwise your first few words might be cut off.
- NEVER, EVER, EVER use patient names instead referring to patients by the time of their appointment (“Dr. Chang’s 9:00 is departing”) or exam room (“Room 3 is ready for her B12”). By not using names, you stay within HIPAA regulations to protect patient privacy.
- Use the name of the person you are contacting, and identify yourself as well. Say everything twice and SPEAK SLOWLY: “Paula to Rachel, Paula to Rachel. Ready for immunizations in exam room 5. Ready for immunizations in room 5.”
- Acknowledge that you’ve heard the communication: “Rachel to Paula, Rachel to Paula, I’m on my way. I’m on my way.”
- Communications should be brief and to the point. Keep the channel open for others to use. Long messages can become garbled and are confusing to the listeners. If you need to give a longer message, use the Walkie-Talkie to flag your team member down: “Rachel to Paula, Rachel to Paula, I have a question. Can we meet at the front desk? I have a question. Can we meet at the front desk?”
- Watch out for the VOX setting on your Walkie. It’s a setting you can typically turn on or off, and you almost certainly want it OFF. VOX means Voice-Operated Exchange and is used in place of the talk button. With VOX, as soon as you start talking it transmits everything you are saying. This is inconvenient for the healthcare setting, because it can pick up what anyone is saying, including patient information. In addition, it’s annoying for your teammates, who don’t want to hear your every word.
- Wear your Walkie-Talkie. It may seem simple, but frequently we see staff members get frustrated when their Walkie-Talkie calls go unanswered because their coworkers have taken their Walkie-Talkies off. It takes practice to get used to the Walkie-Talkies, but they only work if you use them.
Experiment with What Will Work Best for Your Team
After you’ve procured your Walkie-Talkies, test them during a time when you’re not seeing patients. Get comfortable with them first, learning how to use all the bells and whistles, before you get busy. Remember, practice makes perfect, and the more you practice, the more perfect you’ll be!
Walkie-Talkies are great, but they’re not without their limitations. Here are some questions that each Patient Care Team will need to resolve by some experimentation:
- If you have team members working with two or more teams (like front desk, laboratory staff, etc.,) how will they connect to each PCT? Will they use more than one Walkie-Talkie, or will they simply switch channels from one team to another? Is it easy to switch channels on your model?
- How will the clinician be connected to the rest of the team? Some clinicians prefer to be on the same channel as the rest of the team members. Some would rather be on a separate channel to avoid being distracted by messages that don’t pertain to them. Some clinicians will also switch the Walkie-Talkie off and keep it in their pocket until they need something. Then they switch it on and ask the team.
Testing thoroughly and trying various options means that your Walkie-Talkies will become an indispensable tool that you’ll use every day. As a matter of fact, you will wonder how you ever got along without them.
Most organizations want to have a policy and protocol for how walkies will be used in the center. Download an example of an editable protocol that some health centers have used.
While we love our Walkie-Talkies and have seen them work well all over the country, there are a few other options we’ve seen teams use or test with that are worth noting:
- Vocera: Vocera has several products, including voice communications and secure text messaging platforms. In general, Vocera devices are significantly more expensive than Walkie-Talkies, but they also have more functionality. With Vocera, you don’t have to worry about channels, and you can connect with anyone who has a Vocera-enabled device. They are frequently used in hospitals or well-financed practices. You can learn more on the Vocera website.
- Instant Messaging: We’ve seen clinics use Skype, Jabber, Google Hangouts, etc. Clinics that integrate them well—everyone always has the Instant Messaging app open—have great results.
Practice transformation initiatives seek more effective and efficient ways for teams to communicate. Walkie-Talkies can be a very effective and relatively inexpensive tool if used well.
By Pamela Weisse
Updated by Adrienne Meier Mann July 2018