• P J J Herrod, C Barclay, and J D Blakey.
• Department of Orthopaedic Surgery, King's Mill Hospital, Sutton in Ashfield, Nottinghamshire NG17 4JL, UK. pherrod@nhs.net.
• QJM. 2014 Apr 1; 107 (4): 271-6.

BackgroundThe Hospital at Night system has been widely adopted to manage Out-of-Hours workload. However, it has the potential to introduce delays and corruption of information. The introduction of newer technologies to replace landlines, pagers and paper may ameliorate these issues.AimTo establish if the introduction of a Hospital at Night system supported by a wireless taskflow system affected the escalation of high Early Warning Scores (EWSs) to medical attention, and the time taken to medical review.DesignProspective 'pre and post' observational study in a teaching hospital in the UK.MethodsReview of observation charts and medical records, and data extraction from the electronic taskflow system.ResultsThe implementation of a technology-supported Hospital at Night system was associated with a significant decrease in time to documentation of initial review in those who were reviewed. However, there was no change in the proportion of those with a high EWS that were reviewed, and throughout the study a majority of patients with high EWSs were not reviewed in accordance with guidelines.ConclusionIntroduction of a Hospital at Night system supported by mobile technology appeared to improve the transfer of information, but did not affect the nursing decision whether to escalate abnormal findings.

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