Fatovich D M, Jacobs I G, McCance J P, Sidney K L, White R J
Swan District Hospital, Middle Swan, Perth, WA.
Med J Aust. 1998 Aug 3;169(3):143-6. doi: 10.5694/j.1326-5377.1998.tb116015.x.
To evaluate telephone advice given in an emergency department.
Prospective, observational study.
A community-based emergency department in a semi-rural/outer metropolitan setting, between August and November 1995.
All people telephoning the emergency department for medical advice.
Details of all calls, callers and patients were recorded. Within 72 hours, a follow-up call was initiated seeking replies to a series of standardised questions.
Number, timing and duration of calls; appropriateness of the advice given; compliance with the advice; and callers' satisfaction with the service.
Over the four-month period, 1682 calls were received, 58% between 4pm and midnight. There were 33 telephone calls per 100 emergency department attendances. The mean call duration was 3.9 minutes (range, 0.25-25 minutes); 49% of patients were less than 14 years old, and 72% of callers phoned because of spontaneous illness. The advice given was considered inappropriate in only 1.4% of calls. Follow-up calls were made to 1132 people (67%), revealing a non-compliance rate of only 6.9% and a high level of caller satisfaction, with 99% of callers affirming a need for such a service.
The provision of telephone advice by emergency department staff is rated highly by the community and compliance with the advice is strong. Paediatric problems, arising as a result of spontaneous illness, predominate and there is a large bias towards after-hours use of the service. Experienced staff provide better advice.
评估急诊科提供的电话咨询服务。
前瞻性观察性研究。
1995年8月至11月期间，位于半农村/大都市外围地区的一家社区急诊科。
所有致电急诊科寻求医疗建议的人。
记录所有来电、来电者和患者的详细信息。在72小时内，发起随访电话，询问一系列标准化问题的答复。
电话数量、时间和时长；所提供建议的适当性；对建议的依从性；以及来电者对服务的满意度。
在这四个月期间，共接到1682个电话，其中58%在下午4点至午夜之间。每100次急诊科就诊中有33个电话。平均通话时长为3.9分钟（范围为0.25 - 25分钟）；49%的患者年龄小于14岁，72%的来电者因突发疾病致电。仅1.4%的电话所提供的建议被认为不合适。对1132人（67%）进行了随访电话，结果显示不依从率仅为6.9%，来电者满意度很高，99%的来电者肯定需要这样的服务。
急诊科工作人员提供的电话咨询服务在社区中评价很高，对建议的依从性也很强。因突发疾病导致的儿科问题占主导，且服务使用在非工作时间存在很大偏向。经验丰富的工作人员能提供更好的建议。
