Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Prim Health Care Res Dev. 2021 Mar 15;22:e7. doi: 10.1017/S1463423621000098.
Belgium has a problem with inappropriate use of emergency services. The government installed the number 1733 for out-of-hours care. Through a dry run test, we learned that 30% of all calls were allocated to the protocol 'unclear problem'. In only 11.9% of all cases, there was an unclear problem.
The study aimed to determine whether the adjusted protocol 'unwell for no clear reason' led to a safer and more efficient referral and to evaluate the efficiency and safety of the primary care protocols (PCPs). The study ran in cross-sectional design involving patients, General Practitioner Cooperatives and telephone operators. A random sample of calls to 1733 and patient referrals were assessed on efficiency and safety.
During 6 months in 2018, 11 622 calls to 1733 were registered. Seven hundred fifty-six of them were allocated to 'unwell for no clear reason', and a random sample of 180 calls was audited. To evaluate the PCPs, 202 calls were audited. The efficiency and safety of the protocol 'unwell for no clear reason' improved, and safety levels for under- and over-triage were not exceeded. The GP's judged that 9/10 of all patient encounters were correctly referred.
This study demonstrated that the 1733-telephone triage system for out-of-hours care is successful if protocols, flow charts and emergency levels are well defined, monitored and operators are trained.
比利时存在不合理使用急救服务的问题。政府为此开通了 1733 热线，提供非工作时段的医疗服务。通过一次预演测试，我们发现 30%的来电被分配到了“问题不明确”的协议中，但实际上仅有 11.9%的来电属于这种情况。
本研究旨在确定调整后的“无明确原因不适”协议是否能提高分诊的安全性和效率，并评估初级保健协议（PCPs）的效率和安全性。该研究采用了涉及患者、全科医生合作社和电话接线员的横断面设计。我们对 1733 热线的随机抽样来电和患者转诊进行了效率和安全性评估。
在 2018 年的 6 个月期间，有 11622 个电话打到 1733 热线。其中 756 个电话被分配到“无明确原因不适”的协议中，我们对其中 180 个电话进行了随机抽样审核。为了评估 PCPs，我们对 202 个电话进行了审核。“无明确原因不适”协议的效率和安全性得到了提高，且分诊的过度和不足情况均未超出安全水平。全科医生判断，所有患者就诊中，有 9/10 的转诊是正确的。
如果协议、流程图和紧急程度定义明确、得到监测，并对电话接线员进行了培训，那么 1733 夜间医疗服务电话分诊系统是成功的。
