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922-111 Communication Server 1000 to Rls. 6.0 Upgrades for Technicians

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922-111 exam Dumps Source : Communication Server 1000 to Rls. 6.0 Upgrades for Technicians

Test Code : 922-111
Test denomination : Communication Server 1000 to Rls. 6.0 Upgrades for Technicians
Vendor denomination : Nortel
: 27 true Questions

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Nortel Communication Server 1000 to

Microsoft-Nortel note Unified Communications positive aspects | killexams.com true Questions and Pass4sure dumps

news

Microsoft-Nortel note Unified Communications splendid points
  • via Kurt Mackie
  • 07/18/2007
  • A one-year-ancient partnership between Microsoft and Nortel on unified communications know-how, universal as the ingenious Communications Alliance , is bearing fruit. both organizations introduced this week that they've sold more than 430,000 joint-solutions licenses to this point.

    The Alliance lately won three fresh shoppers as well, including Indiana institution, U.ok.-based mostly Worcestershire health assistance and Communications technology services, and an IT and telephony issuer known as 4ward.

    Microsoft and Nortel formed the imaginative Communications Alliance in July of eventual year with the purpose of delivering unified communications options to companies. below the Alliance, the companies initiated joint analysis and pile efforts. They additionally created consumer demonstration centers and engaged in joint earnings and advertising and marketing.

    in the Alliance's prefatory press unencumber, Jeff Raikes, Microsoft's enterprise Division president, stated that the joint unified communications solution would allow a "single identification across electronic mail, voice mail, voice over internet protocol (VoIP) convoke processing, quick messaging and video."

    The Alliance's essential product is referred to as Nortel Converged office, a unified communications gadget that integrates Nortel's VoIP telephony gear with Microsoft's server technology.

    The main accessories of Converged office include:

  • Microsoft office Communicator 2005 soft customer
  • Microsoft office reside Communications Server 2005, and
  • Nortel verbal exchange Server 1000 release 4.5 or bigger IP PBX.
  • there's too a Nortel utility middle component that supports not obligatory capabilities, including internet integration, interactive voice response and get contact with core services.

    Unified communications gets defined in a variety of ways, however in response to the IEEE, it usually encompasses "unified messaging, collaboration and interplay programs." These programs too usually allow real-time and proximate real-time communications. moreover, combined media (voice, email, fax, and many others.) can too be accessed from a single application, independent of the entry machine.

    competitors within the unified communications space is thick with massive names. In March of this year, IBM and Cisco, announced a collaborative exertion on unified messaging client expertise referred to as Unified Communications and Collaboration (UC2). UC2 is based on open technologies, akin to Eclipse evolution atmosphere and the Open capabilities Gateway Initiative framework. Citrix methods and Nokia, amongst others, absorb expressed back for the UC2 platform.

    below the IBM-Cisco unified communications partnership, Cisco plans to sell IBM's Lotus Sametime collaboration retort and IBM plans to promote Cisco's Unified Communications supervisor, Cisco cohesion and Cisco Unified MeetingPlace products. The entire unified communications retort is designed and delivered by way of IBM global know-how functions.

    about the author

    Kurt Mackie is senior tidings producer for the 1105 enterprise Computing community.


    Nortel and Microsoft CEOs define Transformation of industry Communications | killexams.com true Questions and Pass4sure dumps

    big apple — Jan. 17, 2007 — today, Microsoft Corp. CEO Steve Ballmer and Nortel* CEO and President Mike Zafirovski introduced a joint highway map to deliver their shared vision for unified communications. The street map is the outcome of an alliance between Microsoft and Nortel announced in July 2006, and comprises three fresh joint options to dramatically ameliorate company communications by using breaking down the barriers between voice, email, speedy messaging, multimedia conferencing and different types of communication.

    speakme at an event at Studio 8H in Rockefeller core to more than one hundred consumers together with newshounds and analysts, Ballmer and Zafirovski outlined how corporations can ameliorate worker productivity and effectiveness and reduce the fees and complexity of communications. They additionally introduced 11 fresh implementation functions from Nortel and the outlet of more than 20 joint demonstration centers where purchasers can adventure the technology firsthand.

    in exactly six months for the judgement that the alliance become formed, both organizations absorb signed agreements with dozens of customers, and absorb developed a pipeline of hundreds of possibilities who are looking to recognize the benefits of unified communications.

    “we are executing forcefully on the imaginative and prescient of this alliance and absorb made significant progress,” Zafirovski said. “We accomplished the planning levels and at the jiffy are providing unified communications solutions to groups worldwide. Their aim is to proximate the gap between the contraptions they expend to speak and the company applications they expend to race their groups, giving employees the vigour to get expend of advice extra straight away and simply.”

    “The habitual worker gets more than 50 messages each day1 on as much as seven divide instruments or applications,” Ballmer delivered. “software can and may back address the continued problem of managing communications and this challenge is the riding concept in the back of their alliance with Nortel. collectively, they will evolve VoIP and unified communications to integrate total the ways they contact each and every other in an smooth atmosphere, using a single identity throughout telephones, PCs and different gadgets.”

    New options to ameliorate Communications and Collaboration

    Microsoft and Nortel shaped the creative Communications Alliance to attend groups transform enterprise communications by rushing up the transition to voice over cyber web protocol (VOIP) and unified communications. providing on the vision they outlined in July, Microsoft and Nortel today added three fresh options:

  • UC integrated branch. This fresh product from the alliance will contain Nortel and Microsoft® know-how on a single piece of hardware that grants reasonably-priced, terrific and simple-to-installation VoIP and unified communications in far flung offices. The UC integrated fork is planned to be available within the fourth quarter of 2007.

  • Unified Messaging. To simplify customer deployments, native session initiation protocol (SIP) interoperability between the Nortel communique Server one thousand and Microsoft trade Server 2007 Unified Messaging is planned to be available within the 2d quarter of 2007. The solution contains Nortel knowledgeable functions for design, deployment and guide.

  • Conferencing. This fresh solution will prolong the wealthy characteristic set of Nortel Multimedia Conferencing to Microsoft workplace Communicator 2007, delivering a single, common customer adventure consistent across applications equivalent to voice, immediate messaging, presence, and audio- and videoconferencing. The on-premise retort is planned to be obtainable in the fourth quarter of 2007.

  • In 2007, the businesses additionally diagram to prolong their existing unified communications solution — a unified desktop and choice phone for VoIP, e mail, speedy messaging and presence — to the Nortel verbal exchange Server 2100, a carrier-grade commercial enterprise telephony product aiding up to 200,000 users on a single system.

    in addition, Nortel and Microsoft introduced a highway map for 2008 and past for affecting company communications onto a software platform designed to power a better-excellent person journey and reduce total imbue of possession. The road map outlines a few key applications and expertise developments including a unified communications contact middle, Nortel office server, expanded hosted UC solutions, mobility and client options, and utility-mindful networking enhancements.

    “imaginitive communications and collaboration applied sciences are essential to thoroughly enabling Royal Dutch Shell’s international drudgery drive, and key to working at properly quartile in their business. They accept as proper with in and attend the vision Nortel and Microsoft absorb outlined,” spoke of Johan Krebbers, community IT architect at Royal Dutch Shell, who joined Ballmer and Zafirovski onstage for these days’s event. “Over the next a number of years, they diagram emigrate their network to a utility-based mostly communications device built on applied sciences represented through the Nortel and Microsoft alliance.”

    Experiencing VoIP and Unified Communications solutions

    The corporations announced that they've outfitted greater than 20 joint demonstration centers in North the us, Europe and Asia, with greater than 100 additional facilities scheduled to open by means of midyear.

    In a related announcement, Nortel brought 11 core integration functions to attend valued clientele construct, install and aid joint unified communications solutions, including conclusion-to-conclusion challenge management. Nortel already has more than 2,200 VoIP specialists to deliver these features and should add more as deployment ramps up. This group is supported by the 10,000-potent Nortel global features team and a big ecosystem of features partners.

    About Nortel

    Nortel is a diagnosed leader in supplying communications capabilities that enhance the human experience, ignite and vim international commerce, and restful and give protection to the realm’s most crucial suggestions. Their next-generation applied sciences, for both service providers and organisations, span entry and core networks, back multimedia and business-important functions, and assist score rid of nowadays’s obstacles to effectivity, velocity and performance via simplifying networks and connecting americans with counsel. Nortel does company in more than a hundred and fifty nations.

    About Microsoft

    founded in 1975, Microsoft (Nasdaq “MSFT”) is the international leader in utility, features and solutions that back people and groups realize their full talents.

    note to editors: in case you absorb an interest in viewing additional info on Microsoft, gratify debate with the Microsoft web page at http://www.microsoft.com/presspass on Microsoft’s company tips pages. net links, mobile numbers and titles had been suitable at time of publication, however may additionally when you consider that absorb modified. For extra counsel, journalists and analysts can too contact Microsoft’s quick Response group or other usurp contacts listed at http://www.microsoft.com/presspass/contactpr.mspx .

    resourceful Communications Alliance customer support

    BT

    BT international capabilities is the division of BT neighborhood that provides networked IT functions international that enable multinational, multisite companies to thrive and develop in the digital networked economic climate

    “The Nortel and Microsoft alliance has the knowledge to accelerate and simplify the attention of unified communications for a major share of their consumer base. BT leads through instance, and they are already the expend of exchange Server 2007 Unified Messaging with their Nortel telephony device. From this journey and from their position as a number one company of networked IT functions, they consider that the native, requirements-based SIP interoperability that Microsoft and Nortel announced today should simplify deployments and slit back total imbue of possession.”

  • Tom CraigPresident, IP NetworkingBT global services

  • CLSA

    With operations in eleven international locations in the Asia-Pacific vicinity and the financial facilities of ny and London, CLSA is without doubt one of the main monetary powerhouses international. Hong Kong-primarily based CLSA is an award-successful company that gives capabilities in brokerage, funding banking and private equity.

    “We had to connect their regional places of drudgery and headquarters, with more than 1,000 employees, with a device that superior their potential to execute trades and provide reporting information. The ingenious Communications Alliance is delivering a unified communications gear that brings the vim of Nortel’s IP telephony at the side of the collaboration of Microsoft office are alive Communications Server to deliver a solution superior to anything else on the market. it is going to permit us to meet the wants of their clients, meet their regulatory necessities throughout many countries and simplify communications for their personnel. since the imaginative Communications Alliance makes it practicable for us to leverage their existing infrastructure, it's the most cost-efficient retort accessible.”

  • T. RajahChief counsel OfficerCLSA

  • Fred Weber Inc.

    Fred Weber Inc. is the St. Louis enviornment’s chief in heavy and dual carriageway development. primarily based in Maryland Heights, Mo., this $300 million-a-yr, worker-owned enterprise makes a speciality of full-carrier concrete and asphalt paving initiatives and is the region’s greatest materials corporation. The enterprise’s drudgery philosophies nowadays are the identical as those of founder Fred Weber seventy eight years in the past. of those, “The deserve to normally reflect and alter industry practices to more advantageous serve valued clientele” led Fred Weber Inc. to leverage the Nortel and Microsoft relationship.

    “At Fred Weber, their wants are different than other corporations. Their company exists past 4 partitions and a habitual office complicated. This creates a essential want for advantageous and respectable integrated communications. Orchestrating 1,200 personnel across their 25 pile and substances places in addition to their a lot of subsidiary companies may too be a logistical nightmare. The resourceful Communications Alliance solution provided with the aid of Nortel and Microsoft helps resolve this issue, and allows for us to spend more time with their consumers and reply in actual time to their needs.”

  • Phillip HagemannChief advice OfficerFred Weber Inc.

  • overseas SOS

    overseas SOS is the area’s main company of clinical counsel, exotic healthcare and safety functions. With operations in sixty five international locations and a 4,500-effective drudgery drive, overseas SOS helps companies and organizations control the health and safety dangers their travelers, expatriates and international drudgery compel face.

    “presenting tremendous services to their clients globally requires advantageous communication internally and externally. engaging Nortel and Microsoft’s resourceful Communications Alliance relationship gives us the opportunity to allot into sequel a blended technology retort that permits us to raise their core company of offering healthcare and security functions total over.”

  • Todd SchofieldChief expertise OfficerInternational SOS

  • Thomas college

    Thomas faculty, a private faculty in Waterville, Maine, is committed to profession practicing with a practice of teaching college students in enterprise, know-how and training. With greater than 950 undergraduate and graduate college students, and a school of sixty six, Thomas is adopting cutting-part Microsoft and Nortel tips expertise beneath the aegis of the imaginitive Communications Alliance.

    “whereas they are a petite faculty, they absorb the goal of implementing unified communications capabilities to serve their students and college on par with universities that absorb higher enrollments and larger budgets. they now absorb used the Nortel telephony infrastructure for two many years and at the jiffy are using Microsoft office reside Communications Server, so the imaginative Communications Alliance unified communications suite is a herbal extension. The diagram is to set up the innovative Communications Alliance solution to integrate communications, enlarge online coursework, and supply a custom, campuswide immediate messaging skill and a collaborative electronic blackboard ability. The web influence is that they are a 113-year-old establishment that's getting ready their college students for success of their personal and knowledgeable lives, and for management and repair in their communities.”

  • Chris RhodaVice President of counsel ServicesThomas college

  • Nortel CEO and President Mike Zafirovski (left) and Microsoft CEO Steve Ballmer (right) discussing the businesses’ shared imaginative and prescient for unified communications. manhattan, fresh york. Jan. 17, 2007


    Microsoft and Nortel existing Alliance Roadmap | killexams.com true Questions and Pass4sure dumps

    news

    Microsoft and Nortel existing Alliance Roadmap Six months after announcing a telecommunications alliance, Microsoft and Nortel this week presented some early effects of their efforts and outlined a roadmap for future initiatives.

    both groups first introduced their collaboration eventual summer.

    The road map contains three fresh joint options “to dramatically ameliorate enterprise communications by using breaking down the barriers between voice, e mail, quick messaging, multimedia conferencing and different styles of communique,” in keeping with a press release by the two establishments.

    additionally blanketed in the announcement are 11 fresh implementation functions from Nortel and the hollow of greater than 20 joint demonstration facilities where shoppers can adventure the expertise, the commentary persevered.

    furthermore, both companies stated they've signed agreements with dozens of shoppers, and absorb developed a “pipeline of a entire bunch of possibilities who wish to recognise the merits of unified communications.”

    From Microsoft's standpoint, it's total a share of the enterprise's lengthy-term play to merge every benevolent of communications and messaging privilege into a single framework. A 12 months in the past, the industry introduced that it changed into merging its alternate Server neighborhood with its precise-Time Collaboration (RTC) community, and that it had begun to consider of both technologies comprising a "platform."

    the brand fresh neighborhood changed into named the Unified Communications community (UCG) and resides in Microsoft's enterprise Division. The view for the brand fresh group emanated from a vision of adding continuity to a myriad of communications instruments, technologies and modes -- from electronic mail and speedy messaging to Voice over internet Protocol (VoIP), audio/video and web conferencing -- in a unified manner.

    The three fresh joint options introduced by using the alliance this week are named Unified Communications built-in branch, Unified Messaging, and Conferencing.

    When it's accessible within the fourth quarter, UC integrated fork will contain Nortel and Microsoft technology on a single piece of hardware that provides VoIP and unified communications in faraway workplaces.

    Coming a bit earlier within the 2nd quarter, Unified Messaging will aim to simplify client deployments, native session initiation protocol (SIP) interoperability between the Nortel communication Server 1000 and Microsoft change Server 2007. The retort includes Nortel skilled capabilities for design, deployment and guide.

    also coming within the fourth quarter, Conferencing will extend Nortel Multimedia Conferencing to Microsoft office Communicator 2007. It goals to provide a single customer adventure consistent throughout applications reminiscent of voice, rapid messaging, presence, and audio- and videoconferencing.

    This yr, the organizations additionally diagram to prolong their latest unified communications solution — a unified computer and soft cell for VoIP, electronic mail, instant messaging and presence — to the Nortel communication Server 2100, a service-grade enterprise telephony product assisting up to 200,000 users on a single gadget, in response to company statements.

    As for the highway map, the two companies absorb fitted more than 20 joint demonstration centers in North the united states, Europe and Asia, with greater than one hundred extra facilities scheduled to open by way of midyear.

    Nortel has too brought eleven core integration functions to attend consumers construct, install and assist joint unified communications solutions, including conclusion-to-end assignment management. Nortel claims it has already trained greater than 2,200 VoIP consultants to carry these services and may add extra as deployment ramps up.

    about the author

    Stuart J. Johnston has coated technology, notably Microsoft, given that February 1988 for InfoWorld, Computerworld, suggestions Week, and computing device World, as well as for enterprise Developer, XML & net features, and .internet magazines.


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    Communication Server 1000 to Rls. 6.0 Upgrades for Technicians

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    VoIP certification tracks - Nortel's back certifications | killexams.com true questions and Pass4sure dumps

    As mentioned in a previous tip, companies are implementing IP telephony more frequently on their data infrastructures. The increased deployment has created a requisite for certified IP telephony engineers to provide proven, best-of-breed technology.

    The IP telephony certifications Nortel currently offers are divided into four categories: back Specialist, Design Specialist, back Expert, and Design Expert. This tip discusses the Nortel back track.

    Support Specialist

    The back Specialist certifications are intended to demonstrate an individual's talent to implement, operate, and troubleshoot a Nortel Networks IP Telephony solution. The back Specialist certification reflects a candidate with three to six months of undergo that can wield routine technical issues of a gauge Nortel IP Telephony Solution.

    NNCSS - VoIP Succession BCM 3.0

    This certification tests the capability to implement, operate, and troubleshoot the industry Communications Manager 3.0. This certification covers hardware, start-up, data and voice networking, applications, and troubleshooting the BCM. To pass the certification, two exams must be successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and Succession BCM 3.0. The Technology Standards and Protocols for IP Telephony Solutions Exam is an overview of convergence technologies.

    NNCSS - CallPilot Rls. 2.0

    This certification tests the talent to implement, operate, and troubleshoot the VoIP CallPilot 2.0. This certification covers hardware, administration, interoperability with Meridian 1 switches, and security of a single site CallPilot system. To pass the certification, two exams must be successfully completed: Meridian Database and CallPilot 2.0.

    NNCSS - Symposium convoke heart Server or Symposium convoke heart Server Installation and Maintenance

    These two certifications test the talent to implement, operate, and troubleshoot the Symposium convoke heart Server. Both certifications cover hardware, software installation, administration, and maintenance of Symposium convoke heart Server 4.2, Symposium Web Client 4.0, and Symposium Express 3.0. However, the Symposium convoke heart Server certification too tests the architecture, custom configuration and integration of the server. To pass either of these certifications, one exam must be successfully completed: Symposium convoke heart or Symposium convoke heart Installation and Maintenance, respectively.

    NNCSS - Symposium convoke heart TAPI/Agent or convoke heart TAPI/Agent Installation and Maintenance

    These two certifications test the talent to implement, operate, and troubleshoot the Symposium convoke heart TAPI/Agent. Both certifications cover hardware, software installation, administration, and maintenance of Symposium TAPI 2.3 and Symposium Agent 2.3. However, the Symposium convoke heart TAPI/Agent certification too tests the architecture, integration, and custom configuration of the TAPI/Agent. To pass either of these certifications, one exam must be successfully completed: Symposium convoke heart TAPI/Agent or Symposium convoke heart TAPI/Agent Inst/Main, respectively.

    NNCSS - Symposium Express convoke heart or Symposium Express convoke heart Installation and Maintenance

    These certifications test the talent to implement, operate, and troubleshoot the Symposium Express convoke Center. Both certifications cover hardware, software installation, administration, and maintenance of Symposium Express convoke heart 4.2. However, the Symposium Express convoke heart certification too tests the architecture and integration of the convoke center. To pass either of the certifications, one exam must be successfully completed: Symposium Express convoke heart or Symposium Express convoke heart Inst and Maint respectively.

    NNCSS - VoIP Multimedia Communication Server (MCS) 5100 2.0

    This certification tests the talent to implement, operate, and troubleshoot the VoIP Multimedia Communication Server (MCS) 5100 2.0. This certification covers installation of the hardware and software, configuration, maintenance, and management of the Multimedia Communication Server (MCS) 5100 2.0. To pass the certification, two exams must be successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and VoIP Multimedia Communication Server (MCS) 5100 2.0. The Technology Standards and Protocols for IP Telephony Solutions Exam is an overview of convergence technologies.

    NNCSS - VoIP Succession 1000/1000M Rls. 3.0 DB Administrator

    This certification tests the talent to maintain and troubleshoot the VoIP Succession 1000/1000M Rls. 3.0 DB Administrator. This certification covers the architecture, configuration, maintenance, and management of the Meridian 1, Succession 1000 Rls. 3.0, and Succession 1000M Rls. 3.0 using Basic Alternate Route Selection (BARS) and Network Alternate Route Selection (NARS). To pass the certification, two exams must be successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and Succession 1000/1000M Rls. 3.0 DB Administrator.

    NNCSS - VoIP Succession 1000/1000M Rls. 3.0 Installation and Maintenance

    This certification tests the talent to install, configure, and maintain the VoIP Succession 1000/1000M Rls. 3.0. This certification covers the installation, architecture, configuration, maintenance, and management of the Meridian 1, Succession 1000 Rls. 3.0, and Succession 1000M Rls. 3.0, Internet Telephones i2xxx, and Optivity Telephony Manager (OTM) 2.1. To pass the certification, three exams must be successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and Succession 1000/1000M Rls. 3.0 for Technicians, and Succession 1000/1000M Rls. 3.0.

    Support Expert

    The back Expert certifications build on the specialist's abilities by demonstrating their skill to implement, operate, and troubleshoot an advanced Nortel Networks IP Telephony solution. The back Expert certifications reflect a candidate with six to twelve months of hands-on undergo with the talent to lead or assist intermediate-level personnel to maintain knotty Nortel IP Telephony solutions.

    NNCSE - CallPilot 2.0 Unified Messaging Solutions

    This certification tests the talent to implement, operate, troubleshoot and optimize the VoIP CallPilot Unified Messaging Solution 2.0. This certification covers the installation, administration, interoperability, security, upgrade procedures and feature usage for a multi site CallPilot system. To pass the certification, the candidate must first obtain their NNCSS - CallPilot Rls. 2.0. Subsequently, the CallPilot 2.0 Unified Messaging Solutions must be successfully completed to obtain this certification.

    NNCSE - Contact Center

    This certification tests the talent to implement, operate, troubleshoot and optimize the Contact heart Products. This certification covers the candidate's capabilities on the Symposium convoke heart Server (SCCS)/Symposium Express convoke Center/Symposium Web Client, Symposium TAPI Service Provider (TAPI SP), Symposium Agent, and the Symposium Web heart Portal. To pass the certification, the candidate must first obtain their NNCSS - Symposium convoke heart Server and the NNCSS - Symposium convoke heart TAPI/Agent certification. Subsequently, the Contact heart Exam must be successfully completed to obtain this certification.

    NNCSE - IP Convergence Succession 1000/1000M Rls. 3.0

    This certification tests the talent to install, configure, maintain, and optimize the VoIP Succession 1000/1000M Rls. 3.0. This certification covers the configuration, succession fork office (BO), remote office, operation, and Meridian 1 to Succession 1000M 3.0 migration procedures for the Succession 1000/1000M Rls. 3.0, Internet Telephones i2xxx, Remote Office 91xx, and Optivity Telephony Manager (OTM) 2.1. To pass the certification, the candidate must first obtain their NNCSS - VoIP Succession CSE 1000 Rls. 2.0 or the VoIP Succession 1000/1000M Rls. 3.0 Installation & Maintenance certification. Subsequently, another more difficult version of the Succession 1000/1000M Rls. 3.0 Exam must be successfully completed to obtain this certification.

    In the IT industry, certifications are a means to validate an individual's expertise within a specified area. The above Nortel IP Telephony certifications are some of the tools that can demonstrate the capabilities of an IP Telephony back professional. These certifications could not replace years of industry experience, but they attain provide the foundation to back and manage Nortel Voice over IP solutions.

    The next tip will debate Nortel's Design IP Telephony certification track.

    Richard Parsons (CCIE#5719) is a Manager of Professional Services for Callisma Inc., a wholly owned subsidiary of SBC. He has built a solid foundation in networking concepts, advanced troubleshooting, and monitoring in areas such as optical, ATM, VoIP, routed, routing, and storage infrastructures. wealthy resides in Atlanta GA, and is a graduate of Clemson University. His background includes senior and principal consulting positions at International Network Services, Lucent, and Callisma.


    THE 50 STATES | killexams.com true questions and Pass4sure dumps

    THE 50 STATES

    THE 50 STATES<@VM>THE 50 STATES: Maryland to Wyoming

    What's up in your agency?For governments east of the Mississippi, convoke 301-650-2145 or e-mail dyoung@gcn.com. For those west, convoke 301-650-2238 or e-mail twalsh@gcn.com.

    ALABAMA

    VIRTUAL KNOWLEDGE. The condition Legislature has sponsored an online library system that gives registered users access to 53 databases of information. Students, teachers and other Alabama residents can access thousands of full-length articles and definitions, as well as links to numerous Web sites, from the Alabama Virtual Library.

    The site, at www.avl.lib.al.us , was created by a partnership of the state's Supercomputer Authority and Computer Sciences Corp. The site retrieves information from McGraw-Hill Companies of fresh York, Encyclopedia Britannica, Online Computer Library heart Inc. of Dublin, Ohio, EBSCO Industries Inc. of Birmingham, Ala., and several other databases.

    The site runs customized software and resides on a dual-processor 550-MHz Pentium III Dell PowerEdge server with 512 of RAM.

    ALASKABUYER BEWARE. Launched this fall, the Law Department's Consumer Protection Web site offers citizens a location to wield complaints about products or businesses or check out businesses that absorb been reported for fraud or unfair practices. Visitors can download froms in Adobe Portable Document Format, print them out and mail them in.

    The site too gives advice on such issues as credit cards and mail fraud.

    Law Department officials will load consumer complaint information into a searchable database. The department then can discern patterns of unfairness, fraud or deception.

    ARIZONA

    CAMPAIGN FINANCE. Charity begins at home'or a home page. The Secretary of State's Office recently allot the state's campaign finance data online. Secretary of State's Office chief information officer Mike Totherow wrote the program in Delphi from Inprise Corp. The data is stored in a Microsoft SQL Server Version 7.0 database. Visitors to the site, at www.sosaz.com/cfs/CampaignFinanceSearch .htm, can search the site by contributor, committee or date. Home addresses and phone numbers are excluded from the data for privacy reasons, said Jessica Funkhouser, director of the Office of Elections.

    ARKANSAS

    BRAINIACS ONLINE. Attention, total brainiacs. The Board of Education adopted Science Brainium, an online science program, for expend in the state's public elementary and middle schools. Students log on at the site, at us.brainium.com , and enter a user ID and password. The program offers lessons and games on bugs, the solar system and other topics required by Arkansas curriculum standards.

    Science Brainium is the brainchild of Brainium of Salt Lake City. The online program, which works with most browsers, requires the Shockwave plug-in from Macromedia Inc. of San Francisco and at least a 486 PC with 16M of RAM or a Macintosh 68040.

    CALIFORNIA

    DO YOU EVERDREAM? East of San Francisco lies Lafayette, a city of 23,500, which recently outsourced most of its desktop PC services to Everdream Corp. The Fremont, Calif., company will provide city employees with a 24-hour attend desk, Microsoft Office 2000, Windows NT file, print and firewall servers, a virtual private network and a digital subscriber line connection.

    The contract, which is valued at about $85,000 annually, includes 32 Hewlett- Packard PCs with 733-MHz Pentium III processors and 128M of RAM. The city will continue to race its own Web site and services, said Tracy Robinson, the city's administrative services director.

    COLORADO

    SECRET IN SUMMIT. Blind and visually impaired voters in apex County cast their votes using a stealthy ballot for the first time eventual month, thanks to the eSlate 3000, a tablet-sized portable PC developed by Hart InterCivic of Austin, Texas.

    With eSlate, a voice synthesizer reads instructions and the selection of candidates to the voter. The device has big buttons that users click to record their votes.

    In past elections, blind voters had to uncover another person their selection of candidate.

    CONNECTICUT

    SMART ROADS. The Transportation Department received a $2.38 million federal bright Transportation Systems vouchsafe to ameliorate highway and road traffic conditions by using computer systems.

    Connecticut has not yet decided how to expend the funds.

    DELAWARE

    GOT JOBS? Applicants can now apply for condition jobs on the Internet via the condition Personnel Office's Web site, at www.state.de.us/spo . The online application is available for citizens to apply for nearly total positions statewide.

    The condition used Microsoft Visual Interdev 6.0 to build the site. The site accesses a Microsoft SQL 7.0 database and runs on a dual-processor 800-MHz Pentium III Xeon Dell PowerEdge 4400 server with 2G of RAM under Windows NT.

    DISTRICT OF COLUMBIA

    NOTES FROM UNDERGROUND. The Washington Metropolitan area Transit Authority, which operates the Metro subway system, eventual month resumed using computers to operate its trains after 21 months of manual operation. Metro switched from automatic to manual operations in March 1999 after three relays failed, probably because of con- tamination that accumulated over time. Relays control critical functions of the rail cars, including brakes and doors.


    Computer-Based Anesthesiology Paging System | killexams.com true questions and Pass4sure dumps

    The efficient management of operating suites requires observant resource management. Most expenses of a health care organization are personnel related (1), and successful management of medical personnel determines whether an operational unit is a revenue heart or a cost heart (2,3). Patient outcomes, particularly in anesthesiology, depend on the availability of expensive personnel, especially physicians (4,5). In a crisis, rapid mobilization of trained personnel is critical to successful resolution (6).

    Mayo Clinic has a long history of efficient management of personnel, by which the knowledge and expertise of its physicians are leveraged through extensive expend of allied health personnel. One strategy, implemented >100 yr ago, is the expend of visual communication systems to direct physicians and allied health personnel to where they are needed. This began with the introduction of colored wooden door tabs. Each color denoted the condition of a room. For example, a green tab indicated that the patient was in the elbowroom and ready to be seen by a nurse. A blue tab indicated that the patient was ready to be seen by a physician. A red tab indicated that attend was needed for an emergency.

    This communication strategy spread from the outpatient practice to the hospitals, including the operating suites. Subsequently, door tabs were replaced by colored electric lights. A chime was sounded when the condition of a elbowroom changed. This communication strategy was thought to ameliorate the efficiency and trait of care in the operative environment. In 1981, a fresh operating suite was opened at Saint Marys Hospital, 1 of 2 hospitals associated with Mayo Clinic. This prompted updating the communication technology at both hospitals. Electric lights were replaced with video displays suspended from the ceilings or mounted on the walls in the operating rooms (OR), procedure rooms, and back areas.

    This Video Paging System (VPS) used alphanumeric codes to communicate the condition of each patient care location (7). Pages were initiated by expend of electromechanical switches in each OR, procedure room, and preoperative and postoperative location. When a switch was closed (by pushing a button), an alphanumeric code, designating both the location and the individual needed, would be displayed throughout the operative or procedural suite, and in every procedure room, hallway, recovery and waiting area, lounge, office, and cafeteria. In addition, an emergency code was incorporated to rapidly direct staff to a particular location when a cardiac arrest, airway emergency, or other critical event occurred.

    Over time, several problems emerged with the VPS. The black-and-white monitors that displayed the pages burned in after about 18 mo, making the displays unreadable. Replacement monitors were costly and difficult to find. The software was difficult to maintain, and software constraints became unacceptable as the practice grew and evolved. When seven additional ORs were built at Saint Marys Hospital, and OR numbering changed from two digits to three digits, the VPS could not accommodate the change. These problems triggered the conclusion to replace the VPS with a fresh communication system.

    Design Criteria

    Several types of devices were examined as practicable solutions. Cell phones, digital pagers, and personal digital assistants were considered to possibly be less expensive and more springy solutions than the existing hardwired approach. However, these options were rejected as being too conditional on personnel. If the paged individual did not respond, there would be no way to know whether the amend beeper was called, whether the person was unavailable, or to whom the page should be redirected. To respond to a page, one must interact with these devices, which can be impractical during procedures. It was concluded that a hands-free system would be designed and implemented.

    With limited review or documentation, the VPS had evolved on an ad hoc basis with additional functions and a broader geographic distribution. Missing comprehensive system documentation made determining where the current system was used and what information was transmitted challenging. A observant analysis of fresh requirements was completed, redundant and unnecessary functions were eliminated, and the geographic distribution of the fresh system was planned.

    Prototyping technologic solutions occurred simultaneously. A distributed video architecture was rejected because of its inherent instability. Because the cathode-ray tube displays had only an 18- to 24-mo useful life, liquid crystal and light-emitting diode (LED) displays were considered. LED displays were chosen because they absorb a useful life of at least 15 yr and a greater luminosity that prevents washout from fluorescent and natural lighting. These displays are relatively expensive, but the cost can be amortized over a longer useful life. Choosing the size of the characters on the displays was a trade-off between the distance at which the displays could be read and the required information content. The size and information layout of the LED displays were determined by their expected placement, for illustration how low the displays could hang from hallway ceilings. The conclusion was made to develop in-house a configurable, centrally programmable keypad that would replace the electromechanical switches.

    Several distribution architectures were considered. expend of the institutional Ethernet network was an attractive, inexpensive option, but pages could be delayed when network bandwidth claim was greatest. Because pages are time-sensitive, this risk was deemed unacceptable. Therefore, an independent Ethernet network was chosen to drive the system. The computer-based anesthesiology paging system (CAPS) was designed to be upgradeable and easily configured. Software running on gauge hardware is more easily adaptable and requires fewer maintenance personnel. expend of commercially available components too reduces costs for evolution and maintenance (Fig. 1).

    System Specifications

    The CAPS runs on dual-processor, redundant Compaq servers (Compaq Computer, Houston, TX) using SQL Server 7.0 under the Windows NT 4.0 operating system (Microsoft, Redmond, WA). Because the system is used as an emergency indicator, continuous availability is required. A redundant Central Processing Unit architecture satisfies this up time requirement. Software was written in Microsoft’s Visual Basic 6.0 and Visual C++ 6.0. The distribution architecture is a star pattern of Ethernet and RS-422 devices connected by gauge Category-5 cable. Terminal servers connect the RS-422 protocol LED displays and the programmable keypads to the Ethernet network. The server can route daily electronic mail with system statistics and maintenance needs. The CAPS can route a page to a beeper for exigent maintenance problems (Fig. 1). The server software connects to the terminal server ports (one device per port) via device controllers. A simple network management protocol manager restarts failed connections without manual intervention.

    The software design optimizes the handling of fresh pages to assure the shortest practicable time between placing a page and seeing it on the LED displays. If there are no energetic emergency pages, total fresh pages are processed and displayed within 1.5 s. The user initiates a page by either pressing a dedicated microswitch (hot key) or entering a numeric code on the keypad (Fig. 2). The page is sent to the keypad controller via the terminal server. The keypad controller associates the page with a specific keypad, the keypad’s workgroup (e.g., neurologic anesthesia or vascular radiology), and other necessary information. The page is then presented via a Microsoft ActiveX Data expostulate convoke to the SQL Server database engine. The database determines what text is to be displayed on the LED displays and then forwards the text to the queue manager. The database then returns control to the keypad controller, which illuminates an LED above the activated peppery key. If a page for a physician or nurse is initiated from an OR, a light above that room’s door illuminates as a wayfinding aid.

    The queue manager determines the workgroups for a fresh page and inserts the fresh page either into those groups’ new-page queues or emergency queues. Although there are seldom >15 energetic calls, each queue may hold up to 100 calls. At 1.5-s intervals, the pomp controllers query the queue manager for the next page. The pomp controller then forwards that page to each display. If the page is displayed for the first time, a chime sounds. The current time, synchronized with the atomic clock in Boulder, CO, is displayed in the upper privilege corner, except when emergency pages are displayed. The pomp controllers then discharge housekeeping chores (e.g., querying displays for functional status), during the residuum of the 1.5-s interval before querying the queue manager for the next page. After a page has been displayed once, it is placed in the active-page queue. The queue manager then cycles through this queue while any pages are active. Emergency pages are not placed in the active-page queue. When an emergency page is initiated, it is the only page shown on the LED displays, the light above the elbowroom door blinks, and the chime is sounded repeatedly until the page is answered. In the unlikely event that two or more emergency pages are energetic simultaneously, only the emergency pages are cycled until answered.

    The central servers, terminal servers, operating system, and database are total commercial products. The LED displays were initially custom-made products, but the manufacturer has subsequently added them to their gauge product line. These displays are located throughout the hospitals where anesthesia services are provided or anesthesia personnel congregate.

    The programmable keypads were designed in-house and were assembled and tested under contract. The keypads can accept fresh embedded code downloaded from the server. This allows for remote reprogramming of the keypads without maintenance personnel physically interacting with each keypad (i.e., removing >450 keypads from the wall and reprogramming them with a laptop computer). Therefore, upgrading the keypads is rapid and cost-effective.

    An administrative program and several specialized tools for maintenance personnel were developed. The administrative program’s graphical user interface masks the relational database’s complexity and presents a more simplified view of the system. Pages, devices, reports, and other aspects of the system can be managed without expend of the evolution engineering group. This feature allows maintenance personnel to be trained technicians, thereby decreasing the total cost of ownership and freeing the evolution engineering staff for other projects.

    User Functionality

    The CAPS presents two kinds of pages: 1) class page, which is a page for a class of individuals to arrive to a patient location, and 2) person page, which is a page for a specific individual to arrive to a multiple-patient location. Class pages absorb three parts. The prefix characters are alphabetic, denoting the drudgery area (e.g., “N” for the north anesthesia area or “CL” for the catheterization laboratory). The middle characters denote the elbowroom number within that drudgery group (e.g., “N 808” for elbowroom 808 in the north anesthesia area or “CL 109” for elbowroom 109 in the catheterization laboratory). The suffix character denotes the class of person needed in the room. Therefore, complete pages would be “N 808 A,” meaning that an anesthesiologist is needed in elbowroom 808 in the north anesthesia area, or “CL 109 N,” meaning that a nurse anesthetist is needed in elbowroom 109 of the catheterization laboratory. Person pages absorb two parts. The prefix denotes a multiple-patient location (e.g., “P” for postanesthesia care unit or “o” for outpatient recovery). The other characters are numeric, denoting the individual needed. Therefore, a complete person page would be “P49,” meaning that person “49” is needed in the postanesthesia care unit.

    Using CAPS is reasonably straightforward. For example, if a resident physician in cardiac catheterization elbowroom 104 needs to consult with the attending anesthesiologist, the resident pushes the “Physician” button on the keypad mounted on the anesthesia machine (Fig. 3). An LED above the button illuminates, confirming that the page has been received. Every monitor throughout the cardiac catheterization suite, including the elbowroom initiating the page, displays “CL 104 A” in green and chimes briefly (Fig. 4). The page remains on the LED pomp for 1.5 s as the system cycles from page to page. A page cycles every 1.5 s until it is deactivated by a person; there is no timeout feature for pages. When the attending anesthesiologist enters the elbowroom and pushes the “Physician” button, the page is no longer displayed anywhere and the LED above the button turns off. If the resident considers the page to be urgent, the resident pushes the “Urgent” button (Fig. 3) and then the “Physician” button; “CL 104 A” would materialize in orange and cycles with any other pages. If there is an emergency in the procedure room, the two side-by-side emergency buttons are pushed simultaneously (Fig. 3). This action persistently displays “CL 104 A” in sparkling red on every pomp in the catheterization laboratory, and a chime rings until the emergency buttons in the elbowroom are pushed simultaneously. In the unusual event of >1 simultaneous emergency page, the pomp will cycle from emergency page to emergency page every 1.5 s, sounding the chime persistently, until total emergency pages are deactivated.

    Figure 3

    Figure 3

    Figure 4

    Figure 4

    This identical basic feature is available throughout the environment of the CAPS. A peppery key is pushed on the keypad and the defined page is displayed throughout the respective operating or procedural suite. Other examples of practicable pages are shown in Table 1. The peppery keys can vary from keypad to keypad. For example, in the operating suite, anesthesiologists and certified registered nurse-anesthetists are the only licensed providers with peppery keys, whereas in the cardiac catheterization laboratory, a peppery key pages registered nurses who provide sedation care. The system has the talent to add many additional pages through expend of the numeric keys (Fig. 3). For example, by pressing “246” followed by the “Enter” key, a unique page can be displayed, such as “CL 104 MP” for medical photographer. The keypad screen (Fig. 3) displays the keyed page, confirming to the user that the page has been received. If >1 page is entered via the keypad, instead of the peppery keys, the pages are cycled every 1.5 s on the keypad’s screen.

    The LED displays are more useful than the VPS cathode-ray tube monitors, which displayed a maximum of only four black-and-white characters. fancy the CAPS, the VPS prefix character designated the workgroup, two digits identified the elbowroom number, and the suffix character indicated the personnel being paged. The CAPS displays allow a prefix, a elbowroom identifier, and a suffix, for a maximum of 10 characters that can be illuminated in 1 of 3 colors. Rooms can be specified by numbers, short words, or abbreviations. Without the limitations of the VPS, formerly cryptic pages are now displayed in unambiguous text. Whereas “P888” in the VPS meant that the postanesthesia care unit was full, this page is now displayed unambiguously on the CAPS as “PACU FULL.”

    When anesthesia and OR personnel hear the “new call” chime, they can glance at the pomp and read the fresh call. If they miss seeing the fresh page, the system offers shortcuts so one does not requisite to watch total the pages cycle through the display. Personnel indicators in the lower left corner of the pomp (Fig. 5) identify the class of individual required (e.g., anesthesiologist, nurse, or technician). Zone indicators in the upper left corner of the pomp identify the drudgery areas that absorb energetic calls (e.g., “N” for north anesthesia and “B” for cardiovascular anesthesia). If an anesthesiologist accountable for the B zone hears a fresh page chime but misses seeing the fresh page, the anesthesiologist can glance at the pomp (Fig. 5) and celebrate that the fresh convoke was for someone else (e.g., if only “D” is seen in the upper left of the display, only D zone personnel absorb energetic pages). If “B” is in the upper left and if “A” is not in the lower left, then the anesthesiologist no longer needs to ogle at the pomp because the fresh page was for someone else. Pages are sorted numerically within the zone, so people requisite to watch the pomp only until the codes for their rooms are either displayed or passed over. The personnel and zone shortcut indicators are cumulative for total energetic pages and are displayed for total except emergency pages.

    Postimplementation Review

    At Mayo Clinic, each of the two hospitals has a CAPS. During the first 6 mo of operation, there were 8 h of unexpected downtime. There were four additional hours of planned downtime for installing lower priority functions, downloading keypad corrections, installing operating system patches, and correcting heterogeneous problems. After this initial shake-down period, the CAPS was down a total of 14 min in 3 mo (i.e., 0.144 min/day). In contrast, the VPS was down an incurious of 28.3, 29.7, 21.9, and 16.8 min/day in 1996, 1997, 1998, and 1999, respectively. Starting in 2000, the reliability of the VPS began to deteriorate compared with its historic norms. The deterioration became another issue that helped initiate the CAPS project. Despite the rigor of comparing used and fresh technologic systems, the data pomp that the CAPS is more trustworthy than was the VPS.

    Clinical Evaluation

    During the installation of the CAPS, there was a brief period during which neither the VPS nor the CAPS was available in total areas. The VPS was removed in segments as the CAPS was installed, and beepers were used temporarily as a bridging communications medium. Anesthesiologists and nurse anesthetists absorb used beepers for many years for person-to-person communications, such as consultations and outside telephone calls, and as a means to attain individuals when they are outside of the video paging environment (e.g., intensive care units and hospital wards). Because departmental personnel were experienced and restful with beepers and telephones are mounted on every anesthesia machine, it was decided to expend these devices during the transition from the VPS to the CAPS. This allowed comparison of the efficiency of using beepers with the efficiency of using the CAPS.

    Observations of paging with beepers occurred during a 4-day period, 2 days at each hospital. Each day, different ORs were studied on the basis of the implementation schedule of the CAPS. Data were gathered from within a randomly selected OR by recording the time a page was initiated to a beeper (beginning as the number was being dialed) and the time the responder entered the room. Because of the limitation of being able to celebrate only 1 OR at a time and the rapid installation of the CAPS, relatively few pages with beepers were observed (n = 12), total of which were routine, nonurgent calls. When the study was designed, it was expected that there would be 6 days of installation per hospital and, therefore, 12 days of observation for gathering beeper response times. Unfortunately for the study, but fortuitous for the practice, installation took only 2 days per hospital, which reduced the expected number of observations. The original CAPS installation schedule allowed more time for system verification in each drudgery area than was actually needed and so the time allotted for beeper observations was significantly reduced.

    Similarly, observations for the CAPS occurred over a 4-day period, 2 days at each hospital. Data were gathered by recording the time a page appeared on the LED display, which was within 1.5 s of the time the button was pressed from within the OR, and the time the responder entered the room. Because the CAPS displays its pages on LED displays located throughout the surgical suite, several ORs could be observed simultaneously by watching the displays, and more data were collected (n = 57). No exigent or emergency pages were observed.

    The median response time for anesthesiologists paged with a beeper was 2.78 min (range, 1.00–7.23 min). Problem pages did occur, including incorrect beeper numbers that were given to next-shift personnel, multiple pages that were made because the caller was not inevitable that the amend number had been dialed, and missed or ignored pages that required repaging. The median response times for anesthesiologists paged with the CAPS was 1.57 min (range, 0.30–7.20 min). Because of the CAPS design, nobody of the problem pages observed with the beepers were observed with the CAPS. These results are summarized in Table 2 and device 6. A logarithmic transformation was applied to the data to fullfil the distributional assumptions required for the two-sample Student’s t-test. The t-test of the transformed data showed a statistically significant dissimilarity between the response times with beepers and the response times with the CAPS (P = 0.021, t 67 = 2.36). The CAPS had a shorter response time for anesthesiologists than the beeper method.

    Table 2

    Table 2

    Figure 6

    Figure 6

    Discussion

    Mayo Clinic anesthesiologists generally are accountable for more concurrent procedures than is common in an academic practice. For example, one anesthesiologist concurrently cares for two pediatric open-heart patients at Mayo Clinic, whereas the norm is one procedure per anesthesiologist at Duke and Stanford Universities (personal communication). Although there is no arduous evidence that the CAPS directly allows for higher concurrency, the anesthesiology department and the institution absorb concluded that the CAPS is an essential implement that allows for these ratios with safe delivery of anesthesia care. The reasoning is that when an anesthesiologist is busy caring for a patient in one location (e.g., placing a pulmonary artery catheter or inducing anesthesia) and is paged to another location, the page remains visible until it is answered. This prompts colleagues to retort the page, thereby ensuring that clinical problems are rapidly addressed. The system is used to betoken cardiac arrests and other emergencies, initiating an immediate response from many available personnel. The system is too used to page personnel in other services, such as the clinical laboratory, autotransfusion, surgical pathology, and housekeeping. By allowing communication with many groups, the CAPS can be used to manage procedural areas more efficiently.

    The design of the system is consistent with the communication philosophy that has developed at Mayo Clinic in both inpatient and outpatient environments. Patient care sites are equipped with a communication implement that identifies the condition of the room. For the anesthesiology practice, the condition of the elbowroom reflects the personnel needs in the room. If an anesthesiologist is needed, a visual page is displayed throughout the drudgery environment informing both the anesthesiologist and the practice as a entire that assistance is requested in the procedure room. The postimplementation review demonstrates that the CAPS is more trustworthy than the system it replaced, with an incurious downtime of less than one minute per day.

    When comparing the CAPS with a system of beepers, which are the gauge communication devices in many medical centers, the time to retort a page was statistically significantly less when the page was initiated using the CAPS than using a beeper and the opportunity for communication errors are eliminated. This study has a number of limitations. The sample size of beeper paging is petite (n = 12). However, they absorb no judgement to believe that these data are not representative of their beeper paging system. Also, although a statistically significant dissimilarity in response time was detected between the beeper system and the CAPS, the clinical relevance of this dissimilarity is unclear. The clinical relevance of 1.21 minutes response time depends on the clinical situation that prompted the page. If a page is initiated to debate fluid management, it is unlikely that the observed shorter response time would get any difference. However, if the page is to secure assistance for an airway-related problem, then 1.21 minutes could get a significant difference.

    Another limitation of the study is that patient outcome data were not recorded as share of their data collection. total the pages observed were for routine matters (e.g., anesthesia induction, emergence, or routine questions). No emergencies or exigent pages were recorded in either group. A review of the CAPS database shows that there were 7 emergency pages during April 2002 when the paging system covered 97 ORs, 5 recovery rooms, and >46 nonoperative anesthetizing locations. The emergency pages were answered in an incurious of 35 ± 23 seconds. However, there are no data to compare this with emergency response to beeper pages. A much larger study would absorb to be undertaken to demonstrate an sequel on patient outcomes. Although such a study was considered, the anesthesiology practice concluded that it was unwilling to investigate the clinical sequel of paging without the CAPS because of concerns for patient safety and practice efficiency.

    The CAPS has a subtle sequel on the environment of the operating suite because there is not a constant din of overhead audio pages. Instead, a brief chime announces a fresh page to the entire staff. Anesthesiologists in the ORs are not straining to hear garbled pages. Anesthesiology residents and certified registered nurse anesthetists are not waiting in frustration, wondering whether their pages absorb been heard. Pages are persistently visible on ubiquitous displays until answered.

    Mayo Clinic is a big group practice (>1000 attending physicians), and it can be difficult to ensure accountability of total members in a big organization (8). One drawback of using beepers is that staff may ignore or forget pages. With the CAPS, everyone in the procedural suites can note pages and be vigilant of pages that are not answered. The primary value of Mayo Clinic is “the needs of the patient arrive first.” Adherence to this principle encourages staff to respond to unanswered pages. However, even with assistance from colleagues, a interminable pattern of ignoring pages becomes apparent. The CAPS promotes assistance from colleagues when a staff member is occupied with another patient and inhibits a pattern of unanswered pages in a manner not recognized by the anonymity of beepers. As a result, staff members are reluctant to absorb their pages displayed longer than necessary, even though there is no visible duration associated with any given page. The practice-wide result is that staff attend to the needs of patients in a timely manner without authoritarian management measures.

    The CAPS was designed to be a hands-free, reliable, and low-maintenance communication system. The system is more trustworthy than the VPS it replaced. The evolution and installation of the CAPS is associated with anesthesiologists responding more rapidly to paging with the CAPS than to paging with beepers. This may be associated with improved patient outcomes and greater OR efficiency.

    References 1. Marrin CA, Johnson LC, Beggs VL, Batalden PB. Clinical process cost analysis. Ann Thorac Surg 1997; 64: 690–4. 2. Macario A, Vitez TS, Dunn B, McDonald T. Where are the costs in perioperative care? Anesthesiology 1995; 83: 1138–44. 3. DeRiso B, Cantees K, Watkins WD. The operating rooms: cost heart management in a managed care environment. Int Anesthesiol Clin 1995; 33: 133–50. 4. Abenstein JP, Warner MA. Anesthesia providers, patient outcomes, and costs. Anesth Analg 1996; 82: 1273–83. 5. Silber JH, Sean KK, Even-Shoshan O, et al. Anesthesiologist direction and patient outcomes. Anesthesiology 2000; 93: 152–63. 6. Gaba DM, Howard SK, Fish KJ. crisis management in anesthesiology. fresh York: Churchill-Livingstone, 1994: 5–47. 7. Ereth MH, Byer DE, Behrens TL, Tri JL. Computer-based video paging [letter]. J Clin Monit 1989; 5: 217–9. 8. McMahon FB, McMahon JW. Psychology: the hybrid science. Homewood, IL: The Dorsey Press, 1982: 615–6. Attention Authors!

    Submit Your Papers Online

    You can now absorb your paper processed and reviewed faster by sending it to us through their new, web-based Rapid Review System.

    Submitting your manuscript online will be substantive that the time and expense of sending papers through the mail can be eliminated. Moreover, because their reviewers will too be working online, the entire review process will be significantly faster.

    You can submit manuscripts electronically via http://www.rapidreview.com. There are links to this site from the Anesthesia & Analgesia website (http://www.anesthesia-analgesia.org), and the IARS website (http://www.iars.org).

    To find out more about Rapid Review, proceed to http://www.rapidreview.com and click on “About Rapid Review.”

    © 2003 International Anesthesia Research Society Source

    Anesthesia & Analgesia97(1):196-204, July 2003.

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