Clinical Advice Service, Stanford Health Care, Stanford, CA.
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA.
Ann Surg. 2018 Apr;267(4):e67-e68. doi: 10.1097/SLA.0000000000002548.
The aim of this study was to report the utilization and experience of the nurse telephonic triage service for after-hour patient calls in Neurosurgery.
It is challenging for patients to reach their clinicians after-hours in a timely manner. This may result in worse health outcomes for the patients, or inappropriate utilization of emergency rooms and urgent care facilities. Physicians continue to remain overwhelmed with frequent after-hours calls in addition to other clinical responsibilities while on-call.
In August 2015, our institution launched the Clinical Advice Service (CAS) to provide a patient-centric, nurse-run telephone triage service for after-hour calls from Neurosurgery patients. Clinical protocols were created for use by CAS staff by Neurosurgery clinicians.
Between July 2016 and June 2017, CAS has accepted 1021 after-hours calls from Neurosurgery patients. A total of 71.4% of these calls were clinical, and the remaining nonclinical (directions, appointments, general information). CAS escalated 37.3% of the calls to the on-call Neurosurgery physician; 4.8% Neurosurgery patients were triaged to the emergency room by CAS.
CAS has been able to provide well-coordinated care to Neurosurgery patients while reducing physician workload.
本研究旨在报告神经外科夜间患者来电的护士电话分诊服务的使用情况和体验。
患者在夜间及时联系到他们的临床医生具有挑战性。这可能导致患者的健康状况恶化，或者对急诊室和紧急护理设施的不当利用。医生在值班时除了其他临床职责外，还继续面临频繁的夜间来电的困扰。
2015 年 8 月，我们机构推出了临床咨询服务（CAS），为神经外科患者的夜间来电提供以患者为中心、由护士管理的电话分诊服务。临床协议由神经外科临床医生为 CAS 工作人员创建。
2016 年 7 月至 2017 年 6 月期间，CAS 共接听了 1021 个来自神经外科患者的夜间来电。这些来电中，临床来电占 71.4%，其余为非临床来电（方向、预约、一般信息）。CAS 将 37.3%的来电升级到值班神经外科医生；4.8%的神经外科患者由 CAS 分诊到急诊室。
CAS 能够为神经外科患者提供协调良好的护理，同时减轻医生的工作量。
