Rohrer James E, Sheeler Robert D, Furst Joseph W, Bartel Gregory A
Department of Family Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Qual Manag Health Care. 2012 Oct-Dec;21(4):228-34. doi: 10.1097/QMH.0b013e31826d1d9c.
To assess avoidability in after-hours telephone calls. Identification of predictors of avoidable calls is necessary so that system changes can be implemented in the interest of efficiency in patient care.
A new after-hours family physician call service was established in a large group practice to replace some of the resident call shifts and meet patient expectations.
Call logs completed by physicians who were on call.
A total of 131 completed after-hours calls. AVOIDABLE CALL: An after-hours call to a physician that could have been effectively handled by another person, by a communication mechanism, or at another time. ASSESSMENT RESULT: Call defined as avoidable or not avoidable as assessed by the physician on call.
Less than half (41.9%) of calls were avoidable. Run charts failed tests for shifts and runs. Patient age, time of day, and day of the week were not related to being avoidable, but avoidability varied by physician (P = .003).
The after-hours call service experienced high rates of avoidable calls. Avoidability was associated with the physician on call. Reducing avoidable after-hours calls to physicians will require building clinical consensus on which types of calls should be considered avoidable and how avoidable calls should be redirected.
评估非工作时间电话咨询的可避免性。识别可避免电话咨询的预测因素很有必要，这样才能为提高患者护理效率而实施系统变革。
一家大型联合诊所设立了一项新的非工作时间家庭医生电话服务，以取代部分住院医生值班，并满足患者期望。
值班医生填写的通话记录。
总共131次完成的非工作时间电话咨询。可避免电话咨询：指非工作时间拨打给医生的电话，此类电话本可由其他人、通过沟通机制或在其他时间有效处理。评估结果：由值班医生评估电话咨询是否可避免。
不到一半（41.9%）的电话咨询是可避免的。运行图未通过趋势和游程检验。患者年龄、一天中的时间以及一周中的日期与可避免性无关，但可避免性因医生而异（P = 0.003）。
非工作时间电话服务中可避免电话咨询的比例很高。可避免性与值班医生有关。减少非工作时间打给医生的可避免电话咨询，需要就哪些类型的电话咨询应被视为可避免以及应如何转接可避免电话咨询达成临床共识。
