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One of the first principles that a redesign team learns is to "Communicate Directly," and walkie talkies, or two-way radios, are one of the easiest and cheapest ways for members of Patient Care Teams to stay connected to one another. As a matter of fact, tight communication is impossible without direct and frequent communication.

One of the joys of working in a Patient Care Team 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.

Selecting Walkie Talkies

We highly recommend Motorola Talkabout walkies. Motorola has a huge chunk of the market and consistently receive high marks from consumer products testing groups. COBRA walkie talkies are also very good and are reasonably priced. But we have the most experience with Motorolas.

Our current preferred Motorola model is the T4900. A non-rechargeable set of two costs about $30. Rechargeable models, such as the T5500, are available for about $60 a pair, including a charging cradle. Even the rechargeable models can run on batteries (three AA batteries).

Motorola is forever introducing new models, so don't get bogged down looking for any particular model, since the model numbers change frequently. Instead, look for Motorola Talkabout walkies with a 2-mile range (you don't need the 5-mile) and that have channels and subchannels. The subchannels split up the wave range of a specific channel making it much less likely you'll have any interference (static or other folks on your channel).

Walkies have either a digital volume control 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.

Purchasing Walkie Talkies

Where do you buy the darn things? You can find them in good electronics stores (Best Buy, Circuit City, etc.) or online. The website www.compusa.com carries the T5500 for $59.99 a pair. This online source also has a good range of headsets for Motorolas—important to know, because good headsets are hard to find.

Most Patient Care Teams that use walkies also use headsets. There are three models of headsets:

• Earbuds or over the ear models. The sound is not usually as good as with the other headset models, and the embedded microphone is not as handy, but earbuds are discreet and if they fit your ear well, you'll probably love them. Motorola makes an over-the-ear model (#53728), available at www.compusa.com or www.motorola.com for around $10.
• Lightweight headsets. The sound quality is fair and because they are very lightweight, the comfort level is pretty good. These headsets fit around the back of the head, preventing the headset from playing havoc with most hair styles. Motorola makes a lightweight model (#53743) and it costs about $50 at www.compusa.com or www.dogbytecomputer.com
• Professional headsets. This model (Motorola # 53740) offers the best sound quality but is a bit tiring to wear all day for most users. It is worn over the top of the head and is not as comfortable as the behind-the-head model, but this model does have its fans. It costs between $50 and $75 (at the above websites).

We recommend you order a couple different styles to see which one you like best. Be forewarned, though, that with headsets, you get what you pay for. The more expensive headsets are worth the extra expenditure because of the better sound quality and comfort they afford.

Walkie Talkie Etiquette

Well, now that you've bought your walkie talkies, how do use them for optimal efficiency? Here are some tips, gleaned from the combined experience of redesign teams all over the country.

• After you acquire your walkies, read the manual. It sounds obvious, but it's amazing how many people never do this step! Learning about your walkie talkie from the manual will save you much anguish later on.
• Each Patient Care Team should use its own channel, and each team should use the same channel and subchannel every day. For example, Team A uses channel 3, subchannel 5; Team B uses channel 9, subchannel 22.
• Each team member is responsible for replacing the batteries (or recharging them) in his or her own walkie talkie. Non-rechargeable batteries generally last only 1-2 days if the walkie talkies are being used frequently. Each team member is also responsible for storing his or her own walkie talkie so it doesn't walk away!
• At the beginning of every day, the Patient Care Team 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 before speaking to allow the walkie talkie to engage—otherwise your first few words might be cut off.
• Never 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 HIPPA 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.

Experiment with What Will Work Best for Your Team

After you've procured your walkies, 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!

Walkies 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, how will they connect to each team? Will they use more than one walkie talkie, or will they simply switch channels from one team to another?
• 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, so as to avoid being distracted by messages which don't pertain to them.

Testing thoroughly and trying various options will mean that your walkies will become an indispensable tool that you'll use every day. As a matter of fact, you'll wonder how you ever got along without them.