Emergency department telephone advice.

OBJECTIVE

To evaluate telephone advice given in an emergency department.

DESIGN

Prospective, observational study.

SETTING

A community-based emergency department in a semi-rural/outer metropolitan setting, between August and November 1995.

PARTICIPANTS

All people telephoning the emergency department for medical advice.

METHODS

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.

MAIN OUTCOME MEASURES

Number, timing and duration of calls; appropriateness of the advice given; compliance with the advice; and callers' satisfaction with the service.

RESULTS

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.

CONCLUSIONS

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.