O'Cathain Alicia, Knowles Emma, Turner Janette, Nicholl Jon
Medical Care Research Unit, The School of Health and Related Research, University of Sheffield, Sheffield UK.
Fam Pract. 2014 Apr;31(2):193-200. doi: 10.1093/fampra/cmt078. Epub 2013 Dec 12.
In 2010, a new telephone service, NHS 111, was piloted to improve access to urgent care in England. A unique feature is the use of non-clinical call takers who triage calls with computerized decision support and have access to clinical advisors when necessary. Aim. To explore users' acceptability of NHS 111.
Cross-sectional postal survey.
Four pilot sites in England.
A postal survey of recent users of NHS 111.
The response rate was 41% (1769/4265), with 49% offering written comments (872/1769). Sixty-five percent indicated the advice given had been very helpful and 28% quite helpful. The majority of respondents (86%) indicated that they fully complied with advice. Seventy-three percent was very satisfied and 19% quite satisfied with the service overall. Users were less satisfied with the relevance of questions asked, and the accuracy and appropriateness of advice given, than with other aspects of the service. Users who were autorouted to NHS 111 from services such as GP out-of-hours services were less satisfied than direct callers.
In pilot services in the first year of operation, NHS 111 appeared to be acceptable to the majority of users. Acceptability could be improved by reassessing the necessity of triage questions used and auditing the accuracy and appropriateness of advice given. User acceptability should be viewed in the context of findings from the wider evaluation, which identified that the NHS 111 pilot services did not improve access to urgent care and indeed increased the use of emergency ambulance services.
2010年,一项名为NHS 111的新型电话服务在英格兰进行试点,以改善紧急护理的可及性。其一个独特之处在于使用非临床接线员,这些接线员借助计算机化决策支持对来电进行分诊,并在必要时可联系临床顾问。目的:探讨用户对NHS 111的接受度。
横断面邮寄调查。
英格兰的四个试点地区。
对NHS 111近期用户进行邮寄调查。
回复率为41%(1769/4265),49%的人提供了书面意见(872/1769)。65%的人表示给出的建议非常有帮助,28%的人认为比较有帮助。大多数受访者(86%)表示他们完全遵循了建议。73%的人对服务总体非常满意,19%的人比较满意。与服务的其他方面相比,用户对所提问题的相关性以及所给建议的准确性和适当性不太满意。从全科医生非工作时间服务等渠道自动转接至NHS 111的用户比直接拨打者的满意度更低。
在运营的第一年试点服务中,NHS 111似乎为大多数用户所接受。通过重新评估分诊问题的必要性以及审核所给建议的准确性和适当性,接受度有望提高。应结合更广泛评估的结果来看待用户接受度,该评估发现NHS 111试点服务并未改善紧急护理的可及性,实际上还增加了紧急救护车服务的使用。