Belman Shira, Chandramouli Vijayalaxmi, Schmitt Barton D, Poole Steven R, Hegarty Teresa, Kempe Allison
University of Colorado School of Medicine, Department of Pediatrics, Denver, USA.
Arch Pediatr Adolesc Med. 2005 Feb;159(2):145-9. doi: 10.1001/archpedi.159.2.145.
Pediatric after-hours telephone triage by call center nurses is an important part of pediatric health care provision.
To use a computerized database including the after-hours telephone calls for 90% of the pediatricians in Colorado to examine: (1) the epidemiology of after-hours calls during a 1-year period including the volume, seasonality, and timing of after-hours calls, the age of the patients, the presenting complaint, the triage dispositions, and mean rates of calls per pediatrician; (2) the process of care measures at the call center, including waiting times for nurse telephone call-backs, the length of triage calls, and how these factors varied by season; and (3) the frequency and content of calls requesting information but not requiring triage.
Descriptive study.
All telephone calls from the After-Hours Telephone Care Program, Denver, Colo, received between June 21, 1999, and June 20, 2000, were retrieved from a computerized database and categorized by age, season, triage disposition, and algorithm.
The volume, seasonality, timing, age distribution, algorithms used, and triage dispositions of after-hours calls. The reasons for calls requesting information.
During the 1-year period 141 922 calls were returned by the call center. Of the total calls, 88% were for a clinical illness; 5%, for information or advice; 5%, for calls in which the parent could not be recontacted; 1%, for duplicate calls, and 1%, for miscellaneous reasons. Listed in rank order for the year, the 10 most common algorithms used for illness calls were vomiting, colds, cough, earache, sore throat, fever, diarrhea, croup, head trauma, and eye infection. Of illness calls, 21% of callers were told to go in for urgent evaluation, 30% were told to contact their primary care physician either the next day or at a later time, 45% were given home care instructions, and 4% were referred to call the on-call physician.
This study describes the epidemiology of after-hours telephone calls regarding children in 90% of the private practices in Colorado. Data provided are useful in guiding the planning of health care provision, providing staffing of after-hours facilities, and planning for the educational training of telephone care staff. They also highlight opportunities for patient education that might decrease unnecessary after-hours calls.
呼叫中心护士进行的儿科非工作时间电话分诊是儿科医疗服务的重要组成部分。
利用一个计算机化数据库，该数据库包含科罗拉多州90%儿科医生的非工作时间电话记录，以研究：（1）一年期间非工作时间电话的流行病学情况，包括电话数量、季节性、时间分布、患者年龄、就诊主诉、分诊处置方式以及每位儿科医生的平均电话率；（2）呼叫中心的护理措施流程，包括护士回电的等待时间、分诊电话时长以及这些因素如何随季节变化；（3）请求信息但无需分诊的电话的频率和内容。
描述性研究。
从计算机化数据库中检索出1999年6月21日至2000年6月20日期间科罗拉多州丹佛市非工作时间电话护理项目接到的所有电话，并按年龄、季节、分诊处置方式和算法进行分类。
非工作时间电话的数量、季节性、时间、年龄分布、使用的算法以及分诊处置方式。请求信息的电话原因。
在这一年期间，呼叫中心共回电141922次。在所有电话中，88%是关于临床疾病的；5%是询问信息或寻求建议的；5%是无法再次联系到家长的；1%是重复电话；1%是其他原因。按年份排序，用于疾病电话的10种最常见算法依次为呕吐、感冒、咳嗽、耳痛、喉咙痛、发烧、腹泻、哮吼、头部外伤和眼部感染。在疾病电话中，21%的来电者被告知进行紧急评估，30%被告知次日或稍后联系其初级保健医生，45%得到了家庭护理指导，4%被转介致电值班医生。
本研究描述了科罗拉多州90%私人诊所中关于儿童非工作时间电话的流行病学情况。所提供的数据有助于指导医疗服务规划、安排非工作时间设施的人员配备以及规划电话护理人员的教育培训。它们还突出了患者教育的机会，这可能会减少不必要的非工作时间电话。
