Pediatric residents' telephone triage experience. Relevant to general pediatric practice?

OBJECTIVES

To describe a pediatric resident telephone triage system in a tertiary hospital and to determine its relevance to telephone experience in general pediatric practice

DESIGN

An analysis of 514 telephone calls from parents of continuity clinic patients made to pediatric residents. The evaluation included: chief complaint, disposition of call, age of patient, and level of training of the resident answering the call. A comparison was made with published information about a private-practice telephone triage system.

SETTING

Pediatric continuity clinic, Medical College of Georgia, Augusta.

PATIENTS

Children registered in the pediatric resident continuity clinic at the Medical College of Georgia.

RESULTS

The 13 most frequent reasons for calling were some of the most common problems seen in pediatric practice. The disposition of calls was as follows: 272 (53%) were given telephone advice alone, 119 (23%) were offered an appointment for the next day, and 123 (24%) were advised to come to the emergency department immediately. Disposition did not vary with residency level. Both chief complaints and disposition of calls were similar to those reported in a private-practice nurse triage system.

CONCLUSIONS

Answering telephone calls in a residency telephone triage system, when combined with a curriculum that includes next-day monitoring, feedback from a preceptor, and seminar discussions focused on telephone management situations, is a valuable training experience and is relevant for residents going into private pediatric practice.