Implementation of a Web-Based Provider Care Team System at the VA North Texas Health Care System.

Concern that our Department of Veterans Affairs (VA) suffers low relational coordination led us to seek a system that might improve domains of relational coordination. The lack of an accurate system to identify the physician caring for a patient at any given time was a ready target. We conducted forward effect analysis, a novel methodology we adapted from our shared experience in software development and entrepreneurship. This study sought to implement a Web-based patient care team system in the critical care units at the VA North Texas Health System. Surveys were distributed to nurses before and after the intervention. Nursing confidence in the system improved from a median of 40% to 70%, and median satisfaction improved from 20% to 80%. Forty percent of nurses believed the old paging system resulted in harm to patients, compared with none with the new paging system. This study demonstrates technical and organizational implementation of a paging system as a two-sided platform with the ability to improve relational coordination between these sides.