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[关于设立呼叫中心以减少儿科急诊室非预约就诊和不合理会诊的可行性研究]

[Feasibility study of a call centre to reduce non-scheduled visits and unjustified consultations in pediatric emergencies units].

作者信息

Stagnara Jean, Vermont Jacques, Jacquel Julie, Bagou Gilles, Masson Sandrine, Kassaï Behrouz, Chatelain Pierre

机构信息

Hospices civils de Lyon, groupe hospitalier Est, hôpital Femme-Mère-Enfant, service d'accueil et d'urgences pédiatriques, RIPPS, 69500 Bron, France.

出版信息

Presse Med. 2010 Nov;39(11):e258-63. doi: 10.1016/j.lpm.2010.03.019. Epub 2010 Jun 20.

Abstract

INTRODUCTION

Non-justified and non-scheduled visits to emergency units are ever increasing and consequently overburden their staff. Because it seems necessary to meet this heavy demand of urgent health care, a possible solution could be to set up phone call centers dedicated to pediatric care. First, when people call the emergency number, the SAMU doctors will field these calls and immediately determine the degree of urgency of the situation before transferring the call to the appropriate standardized call center who will then advise the caller as to how to proceed.

OBJECTIVE

To access the technical feasibility of setting up this call center which will be in place with the already existing emergency call system and also to ascertain if the system will indeed reduce the number of unnecessary emergency medical consultations.

METHODS

The standardized information and advice given by this call center concerning fever, diarrhoea, crying, head trauma, respiratory obstruction in the young infant comes from the consensus of the association of Courlygones pediatric doctors. As a follow up to the initial contact with the caller, nurses call the families back seven days later to find out if the families did finally take their child to the emergency room or not and also to see if the callers retained the necessary advice given through the call center. Finally, the nurses request that the families assess their own satisfaction will this new call service.

RESULTS

Over a period of 97 days, 250 calls were fielded. In 84% of the cases (n=210/250), calls came from parents and most of them (109/198, 55.05%) had only a single child. On average, each call lasted between 5 to 8 minutes. 97% of the callers (n=178/183) were satisfied by the advice given. Following the call, 128 callers /215 (59.53%) asked an additional medical advice within 20 h and 61.71% (n=79/128) of them actually took their child to a scheduled medical consultation. Only 2.34% of the 128 callers were finally hospitalized.

DISCUSSION

Our results confirm the technical feasibility to set up a call centre dedicated to paediatrics and its positive impact on the number of non-scheduled and non-justified visits to emergency units.

摘要

引言

对急诊科进行无正当理由且非预约的就诊人数不断增加,从而使急诊科工作人员负担过重。由于满足这种紧急医疗护理的巨大需求似乎很有必要,一个可能的解决方案是设立专门的儿科护理电话中心。首先,当人们拨打急救电话时,急救医疗服务(SAMU)的医生会接听这些电话,并在将电话转接到适当的标准化呼叫中心之前,立即确定情况的紧急程度,然后呼叫中心会告知来电者如何处理。

目的

评估设立该呼叫中心与现有紧急呼叫系统配合的技术可行性,并确定该系统是否真的会减少不必要的紧急医疗咨询次数。

方法

该呼叫中心提供的关于发热、腹泻、哭闹、头部外伤、幼儿呼吸阻塞的标准化信息和建议来自库尔利贡斯儿科医生协会的共识。在与来电者首次联系后,护士在七天后给这些家庭回电,了解这些家庭最终是否带孩子去了急诊室,以及来电者是否记住了通过呼叫中心提供的必要建议。最后,护士要求这些家庭评估他们对这项新呼叫服务的满意度。

结果

在97天的时间里,接听了250个电话。在84%的案例(n = 210/250)中,电话来自家长,其中大多数(109/198,55.05%)只有一个孩子。平均每个电话持续5到8分钟。97%的来电者(n = 178/183)对所提供的建议感到满意。通话后,128名来电者/215名(59.53%)在20小时内寻求了额外的医疗建议,其中61.71%(n = 79/128)实际上带孩子去进行了预约的医疗咨询。128名来电者中只有2.34%最终住院。

讨论

我们的结果证实了设立专门的儿科呼叫中心的技术可行性及其对非预约和无正当理由前往急诊科就诊人数的积极影响。

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