High call volume at poison control centers: identification and implications for communication

Abstract

Context High volume surges in health care are uncommon and unpredictable events. Their impact on health system performance and capacity is difficult to study. Objectives To identify time periods that exhibited very busy conditions at a poison control center and to determine whether cases and communication during high volume call periods are different from cases during low volume periods. Methods Call data from a US poison control center over twelve consecutive months was collected via a call logger and an electronic case database (Toxicall®). Variables evaluated for high call volume conditions were: (1) call duration; (2) number of cases; and (3) number of calls per staff member per 30 minute period. Statistical analyses identified peak periods as busier than 99% of all other 30 minute time periods and low volume periods as slower than 70% of all other 30 minute periods. Case and communication characteristics of high volume and low volume calls were compared using logistic regression. Results A total of 65,364 incoming calls occurred over 12 months. One hundred high call volume and 4885 low call volume 30 minute periods were identified. High volume periods were more common between 1500 and 2300 hours and during the winter months. Coded verbal communication data were evaluated for 42 high volume and 296 low volume calls. The mean (standard deviation) call length of these calls during high volume and low volume periods was 3 minutes 27 seconds (1 minute 46 seconds) and 3 minutes 57 seconds (2 minutes 11 seconds), respectively. Regression analyses revealed a trend for fewer overall verbal statements and fewer staff questions during peak periods, but no other significant differences for staff-caller communication behaviors were found. Conclusion Peak activity for poison center call volume can be identified by statistical modeling. Calls during high volume periods were similar to low volume calls. Communication was more concise yet staff was able to maintain a good rapport with callers during busy call periods. This approach allows evaluation of poison exposure call characteristics and communication during high volume periods.

Software prototyping

“…PCC specialists in poison information (SPIs) interface with healthcare professionals over the telephone and provide recommendations in the treatment of poisoned patients [4]. However, this reliance on telephonic communication can result in miscommunication, data loss, and error, especially in these settings of high communication loads, frequent interruptions, disaster scenarios [5], and/or routine surges in calls [6]. Health information exchange (HIE) has been proposed to improve information sharing between PCCs and EDs, thus improving decision-making, continuity of care, and reducing errors [7,8].…”

Virtual Urgent Care Quality and Safety in the Time of Coronavirus

“… 25 Therefore, previous telephonic quality and safety measures such as risks posed by dropped calls were applied to VUC. 26 Separately, telehealth frameworks also suggest that these “dropped sessions” 17 represent a continuous performance improvement benchmark, and that technical issues should be assessed. 18 Visit failures (recorded as terminations in the EHR) are mutually exclusive categories—“no show,” “criteria unqualified” (e.g., an out-of-state patient prior to revised CMS guidelines), and “connection issue” (technological failure).…”

Simple Workflow Changes Enable Effective Patient Identity Matching in Poison Control

“…We previously identified vulnerabilities and inefficiencies in the ED–PCC collaboration system that can lead to miscommunication, data loss, and error, which must be addressed to ensure patient safety. 3 4 5 Examples of safety vulnerabilities include: difficulty establishing synchronous verbal communication via telephone, discussion of multiple patients during the same telephone conversation, and communication with nonclinical staff members. Additionally, any information moved among patient care settings via phone may or may not be documented for continued use by the recipient health care facility.…”