Identification of common themes from after-hour telephone calls made to urology residents.

OBJECTIVES

To characterize the content and sources of after-hour telephone calls from a general urology practice so that common themes can be identified and incorporated into the education of urology residents.

METHODS

After-hour telephone calls were prospectively assessed for 6 months by a single senior urology resident. Calls occurring on weekends/holidays and between 5 PM and 8 AM on weekdays were directly referred to the on-call resident. The day of week, time, source, initiating event, and required action from each call was recorded. Exclusion criteria included calls regarding established hospital urology in-patients and duplicate calls from individual patients calling more than once within 24 hours.

RESULTS

Eighty-seven calls were collected. Seventy percent occurred on weekends, primarily between 8 AM and 5 PM. The most common source was from outpatients (56%) followed by emergency room physicians (30%). In general, 61% and 26% of all calls regarded new urologic symptoms and postoperative issues, respectively. Urinary calculi were the most common specific reason for a call, followed by lower urinary tract symptoms and hematuria. An acute urologic evaluation was required for 27% of all telephone calls. Nine patients (10%) required admission within 48 hours of calling.

CONCLUSIONS

The education of urology residents should emphasize telephone evaluations of patients who present with urinary calculi and common postoperative issues. The number of after-hour calls may be able to be reduced if patients and nonurologist physicians are also educated in the management of nonacute urologic problems.