Content Analysis of the Free COVID-19 Telephone Consultations Available during the First Wave of the Pandemic in Japan

Abstract

This cross-sectional study aimed to (1) describe the unclassified contents of telephone consultation services provided by a public health center during the first wave of COVID-19 in Japan and (2) examine whether the contents required assistance from public health nurses (PHNs). We analyzed a total of 207 calls in which the purpose of the call was unclassified into pre-set categories. PHNs transcribed the exact text of the consultation conversations recorded from 25 March to 20 April 2020 in City A. Approximately half of the calls were from residents. Seven categories were extracted through a qualitative content analysis. The most common topic was infection control measures, where the presence of COVID-19 infection was assumed (n = 62); the second most common was extreme anxiety and fear of infection (n = 50). Questions about the COVID-19 response system (n = 30), discrimination and misunderstandings about COVID-19 (n = 24), and response measures for COVID-19 outbreaks within organizations (n = 18) were also included. The unclassified consultations included various topics, several of which required the expertise of a PHN. Each local government should consider sharing and task-shifting telephone consultation services among PHNs and other staff to reduce their burden and allow them to concentrate on conducting infection control more effectively.

Task shifting healthcare services in the post-COVID world: A scoping review

“…PHN identified tasks, including contact tracing, health monitoring, hospitalisation coordination and consultation with residents, to be shifted onto part-time PHN and other nursing and support staff to forestall organisational dysfunction [45]. Similarly, analysis of teleconsultations by PHN during the first infection wave by Yoshioka-Maeda et al [46] showed that conversations were majorly about prevention measures and referral pathways, which PHN need not have attended. Managers were advised to let PHN handle essential consultations and shift teleconsultations onto low-level staff and office workers by developing script-based manuals and proper training.…”

“…This will help reduce mortality, morbidity, stressors and burn outs. PHN at Japanese public health centers shifted teleconsultations onto office staff as discussed previously [46] Yoshioka-Maeda [51] reported PHN developing web-based data systems to exchange COVID-19 patient information and shift hospital coordination and clerical tasks to office staff, and inventory management, including management of personal protective to external companies. TS through web-based systems saved nursing time, decreased workloads and improved efficiency in allocating supplies.…”

“…Similarly, analysis of teleconsultations by PHN during the first infection wave by Yoshioka-Maeda et al [46] showed that conversations were majorly about prevention measures and referral pathways, which PHN need not have attended. Managers were advised to let PHN handle essential consultations and shift teleconsultations onto low-level staff and office workers by developing script-based manuals and proper training.…”

Task shifting healthcare services in the post-COVID world: A scoping review

“…Teleconsultations by PHN during the first wave focused on prevention measures and referral pathways, prompting managers to shift these tasks to lower-level staff and office workers using scripted manuals. This allowed PHN to concentrate on infection control and management [44]. In Ghana, the central teaching hospital adapted staff roles and schedules to transfer medication prescribing and ART dispensing from pharmacists to nurses, ensuring ART continuity and reducing patient waiting times at HIV clinics [54].…”

Evolution of rehabilitation services in response to a global pandemic: reflection on opportunities and challenges ahead

“…In Japan, dedicated virtual consultation services were introduced early in the pandemic through the Japanese Infectious Disease Prevention Act, where public health centers became responsible for infectious disease control and prevention ( 55 , 56 ). An improved version of teleconsultation service, supported by the local government, was reported in Hiroshima city, and included a hotline for COVID-19 center available 24-hours a day, providing online consultation in 10 languages.…”