[Telephone triage performed by emergency room physicians].

OBJECTIVE

To determine the applicability and utility of a telephone triage performed by physicians in a pediatric emergency department (PED).

PATIENTS AND METHOD

All the telephone consultations registered between 2003-10-1 and 2004-10-3 were reviewed. The variables analyzed were: telephone call record (n = 2,560), compliance with the advice given (randomized sample of patients who were not referred to the PED and all patients who were referred) and parent satisfaction (callers over a 1-month period were contacted). A protocol for answering queries was organized and residents received specific training.

RESULTS

There were 59,088 episodes and 2,560 calls were registered (1 call/23 episodes). Forty-eight percent of the calls were received between 5 and 11 pm. All calls were answered by a physician (72% residents, 28% attending physicians). The most frequent reason for calling was to seek advice on symptoms. Eighty-two percent of the calls were resolved through telephone instructions to be carried out in the home. A total of 274 patients were advised to attend the PED, but 29% did not attend, usually because the child's symptoms improved. Twenty patients were admitted to the hospital (6 to wards, 14 to the observation unit). Of the patients not advised to attend, 21% attended the PED and 0.9% were admitted (compared with 7.2% in the referral group, p = 0.0001). More than 90% of the families questioned were satisfied with the advice given. Seventy-five percent would have attended the PED if telephone consultation had not been available. By giving telephone advice, we avoided 115 visits in 1 month.

COMMENTS

If special training programs and answering systems are established after a training period, telephone consultation in a PED is a safe and useful method of performing patient triage. Satisfaction among families was high.