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Completeness and quality of text paging for subspecialty consult requests
  1. Chi D Chu1,
  2. Delphine S Tuot1,
  3. James D Harrison2,
  4. Jonathan Duong2,
  5. Adam Luxenberg3,
  6. Raman R Khanna2
  1. 1 Division of Nephrology, University of California San Francisco, San Francisco, California, USA
  2. 2 Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
  3. 3 Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
  1. Correspondence to Chi D Chu, University of California, 533 Parnassus Avenue, U404, San Francisco, CA, USA; Chi.Chu{at}


It is unclear whether previously developed frameworks for effective consultation apply to requests initiated by alphanumeric text page. We assessed a random sample of 210 text paged consult requests for communication of previously described ‘essential elements’ for effective consultation: reason for consult, level of urgency and requester contact information. Overall page quality was evaluated on a 5-point Likert scale. Over 90% of text paged consult requests included contact information and reason for consult; 14% indicated level of urgency. In ordinal logistic regression, reason for consult was most strongly associated with quality (OR 22.4; 95% CI 8.1 to 61.7), followed by callback number (OR 6.2; 95% CI 0.8 to 49.5), caller’s name (OR 5.0; 95% CI 1.9 to 13.1) and level of urgency (OR 3.3; 95% CI 1.6 to 6.7). Results suggest that text paged consult requests often include most informational elements, and that urgency, often missing, may not be as ‘essential’ for text pages as it was once thought to be.

  • Health services administration & management
  • quality in healthcare
  • medical education & training

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  • Contributors Research idea and study design: CDC, DST and RRK; data acquisition: RRK; statistical analysis: CDC, DST and RRK; data interpretation: CDC, DST, JDH, JD, AL and RK; manuscript drafting and revisions: CDC, DST, JDH, JD, AL and RRK; supervision: DST and RRK. CDC is the guarantor.

  • Funding Dr Chu currently receives funding by the Ruth L. Kirschstein National Research Service Award (1F32DK122629-01) from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

  • Competing interests Dr Khanna helped develop CareWeb, which has been licensed by Voalte. Drs Chu, Tuot, Harrison, Duong and Luxenberg have nothing to disclose.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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