Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Telemed J E Health. 2010 Dec;16(10):1012-6. doi: 10.1089/tmj.2010.0102. Epub 2010 Nov 8.
the H1N1 (subtype hemagglutinin 1 neuraminidase 1) influenza pandemic of 2009 was associated with a large increase in demand for primary care office visits. However, many patients with H1N1 symptoms or exposure could be assessed and treated with telephone protocols.
specific H1N1 influenza telephone protocols were developed by Mayo Clinic physicians using Centers for Disease Control recommendations. Using symptom calls to a primary care practice in the United States, we captured nurse telephone triage recommendations, telephone antiviral prescriptions, and what callers would have done without telephone advice. We retrospectively analyzed all symptom calls from July 2009 through January 2010.
call volume was 5,596 calls monthly during the peak influenza months, which was 56% above the monthly average of 3,595 calls for the nonpeak months (p < 0.001). The calls during October 2009 were 111% over the nonpeak months (p < 0.001). In October 2009, telephone triage nurses gave 412 prescriptions for antivirals accounting for 5.4% of calls and 39% of all telephonic prescriptions for that month. In the peak H1N1 month of October, there were 1,522 callers who intended to stay home for their care. For the same month, triage nurses suggested 3,250 of the callers stay home. For an October 2009 appointment capacity of 35,126 visit slots, a potential 5% capacity was preserved.
a telephone triage solution for the acute demands of influenza H1N1 demonstrated how patients had needs met telephonically while preserving medical access for others.
2009 年的 H1N1（亚型血凝素 1 神经氨酸酶 1）流感大流行导致对初级保健门诊就诊的需求大幅增加。然而，许多有 H1N1 症状或接触史的患者可以通过电话协议进行评估和治疗。
梅奥诊所的医生使用疾病控制中心的建议制定了特定的 H1N1 流感电话协议。我们通过对美国一家初级保健诊所的症状电话进行呼叫，捕获了护士电话分诊建议、电话抗病毒处方以及如果没有电话咨询来电者会怎么做。我们回顾性分析了 2009 年 7 月至 2010 年 1 月的所有症状电话。
流感高峰期每月电话量为 5596 次，比非高峰期每月平均 3595 次高出 56%（p < 0.001）。2009 年 10 月的电话量比非高峰期高出 111%（p < 0.001）。2009 年 10 月，电话分诊护士开出了 412 份抗病毒处方，占电话量的 5.4%，占当月所有电话处方的 39%。在 H1N1 流感高峰期的 10 月，有 1522 名来电者打算在家中接受治疗。对于同月，分诊护士建议 3250 名来电者留在家中。对于 2009 年 10 月 35126 个预约就诊名额的容量，潜在保留了 5%的容量。
针对 H1N1 流感的急性需求的电话分诊解决方案展示了如何通过电话满足患者的需求，同时为其他人保留医疗机会。
