Dale J, Crouch R, Patel A, Williams S
Department of A&E Medicine, King's College School of Medicine and Dentistry, London.
J Accid Emerg Med. 1997 Jan;14(1):21-3. doi: 10.1136/emj.14.1.21.
To investigate the expectations of patients when they phone the accident and emergency (A&E) department, how this relates to the advice they receive, the action they subsequently take, and their satisfaction with the service.
The study was undertaken at an inner city hospital in south east London.
597 calls to the department were documented during the study period, and callers for whom a phone number had been recorded were followed up by structured interviews carried out by a trained interviewer within 72 h of the call. Up to three attempts were made to contact each patient. The interviews were conducted at various times of the day to avoid excluding people with different work or social patterns.
The interviewer was able to contact 203 patients within 72 h of their call to the A&E department. Of these 197 (97%) agreed to participate. Almost two thirds stated that when they phoned A&E they anticipated receiving self care advice; 11% expected to be advised to see or contact their general practitioner. Only a quarter of callers stated that they had expected to be told to attend A&E. There was disagreement between the advice that nurses documented as having been given, the advice the caller recalled receiving, and the action the patient subsequently took. Even so, 107 (55%) callers were very satisfied and 62 (32%) were satisfied, while 11 (6%) were dissatisfied with the telephone consultation; 15 (8%) were unsure. In all, 170 (87%) thought the advice they received was helpful.
Understanding the reasons why patients phone A&E departments and their expectations should contribute to developing more responsive and effective services.
调查患者致电事故与急救（A&E）部门时的期望，以及这些期望与他们所获建议、随后采取的行动及其对服务满意度之间的关系。
该研究在伦敦东南部的一家市中心医院进行。
在研究期间记录了597个打给该部门的电话，对记录了电话号码的来电者，由一名经过培训的访谈者在来电后72小时内进行结构化访谈跟进。对每位患者最多进行三次联系尝试。访谈在一天中的不同时间进行，以避免排除具有不同工作或社交模式的人群。
访谈者能够在患者致电A&E部门后的72小时内联系到203名患者。其中197人（97%）同意参与。近三分之二的人表示，他们致电A&E时预期会得到自我护理建议；11%的人期望得到去看或联系全科医生的建议。只有四分之一的来电者表示他们原本期望被告知前往A&E就诊。护士记录的已给出的建议、来电者回忆收到的建议以及患者随后采取的行动之间存在分歧。即便如此，107名（55%）来电者非常满意，62名（32%）满意，而11名（6%）对电话咨询不满意；15名（8%）不确定。总体而言，170名（87%）认为他们收到的建议有帮助。
了解患者致电A&E部门的原因及其期望，应有助于开发更具响应性和有效性的服务。
