Identifying avoidable switchboard delays in England’s NHS hospitals: phase one of the national SWITCH project
Authors:   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Ghelani Rahul , Maclean Edd ,   William Harvey Research Institute, Queen Mary University of London, Mile End Road, Bethnal Green, London, E1 4NS, Adra Myra ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Anderson Sarah ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Arora Anshu ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Aylward Charlotte ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Bindra Harmit ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Carter Christine ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Denning Max ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Dib Naim ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Egan Sile ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Ganis Laura ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Illing Heather ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Kerwat Doaa Rajab ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Knight Megan ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Maden Samantha ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Murphy Mark ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Myers Sam ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Mootein Ganesha ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Penicott Hannah ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Rooney Marie-Claire ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Seehra Harpiar ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Shams Farzard ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Yauwan Daniel ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Yogarajah Ragave ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR, Zhu Hongguang ,   The Royal London Hospital (Barts Health NHS trust), Whitechapel Rd, Whitechapel, London E1 1FR
Published: June 2021

Background: Inter-hospital communication frequently requires mediation via a switchboard. Identifying and eliminating switchboard inefficiencies may improve patient care. Methods: All 175 acute hospital switchboards in England were contacted six times. Call contents and duration were recorded. No clinician calls or bleeps were connected. Results: The mean delay before contacting a switchboard operative was 55±46 seconds. 115 hospitals (66%) used automated switchboards; 34 of these (30%) had infection control messages. Robot operators introduced an additional 40 second delay versus humans (mean 70.3±28 versus 29.8±23 seconds, p<0.0001). Multivariate analysis identified robot operators (HR 5.1, p<0.0001) and infection control messages (HR 2.9, p=0.003) as predictors of delays over 60 seconds. Conclusions: There are significant avoidable delays in contacting switchboard operatives across England. Quality improvement is underway.