Wingfield Tom, Beadsworth Mike Bj, Beeching Nicholas J, Gould Susan, Mair Luke, Nsutebu Emmanuel
Liverpool School of Tropical Medicine, Liverpool, UK, The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK and Karolinska Institutet, Stockholm, Sweden
Liverpool School of Tropical Medicine, Liverpool, UK and The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.
Clin Med (Lond). 2020 Jul;20(4):424-429. doi: 10.7861/clinmed.2019-0201.
Many secondary care departments receive external advice calls. However, systematic advice-call documentation is uncommon and evidence on call nature and burden infrequent. The Liverpool tropical and infectious disease unit (TIDU) provides specialist advice locally, regionally and nationally. We created and evaluated a recording system to document advice calls received by TIDU.
An electronic advice-call recording system was created for TIDU specialist trainees to document complex, predominantly external calls. Fourteen months of advice calls were summarised, analysed and recommendations for other departments wishing to replicate this system made.
Five-hundred and ninety calls regarding 362 patients were documented. Median patient age was 44 years (interquartile range 29-56 years) and 56% were male. Sixty-nine per cent of patients discussed were referred from secondary healthcare, half from emergency or acute medicine departments; 43% of patients were returning travellers; 59% of returning travellers had undifferentiated fever, one-third of whom returned from sub-Saharan Africa; 32% of patients discussed were further reviewed at TIDU. Interim 6-month review showed good user acceptability of the system.
Implementing an advice-call recording system was feasible within TIDU. Call and follow-up burden was high with advice regarding fever in returned travellers predominating. Similar systems could improve clinical governance, patient care and service delivery in other secondary care departments.
许多二级医疗部门会接到外部咨询电话。然而,系统性的咨询电话记录并不常见,关于电话性质和负担的证据也很少见。利物浦热带病和传染病科(TIDU)在当地、地区和全国范围内提供专业建议。我们创建并评估了一个记录系统,用于记录TIDU接到的咨询电话。
为TIDU专科实习生创建了一个电子咨询电话记录系统,用于记录复杂的、主要是外部的电话。对14个月的咨询电话进行了总结、分析,并为希望复制该系统的其他部门提出了建议。
记录了关于362名患者的590个电话。患者年龄中位数为44岁(四分位间距29 - 56岁),56%为男性。所讨论的患者中有69%是从二级医疗转诊而来,其中一半来自急诊科或急性内科;43%的患者是归国旅行者;59%的归国旅行者有不明原因发热,其中三分之一是从撒哈拉以南非洲返回;所讨论的患者中有32%在TIDU进行了进一步复查。6个月的中期评估显示该系统具有良好的用户接受度。
在TIDU实施咨询电话记录系统是可行的。电话咨询和后续跟进负担较重,主要是关于归国旅行者发热的咨询。类似的系统可以改善其他二级医疗部门的临床管理、患者护理和服务提供。