Use of a telephone advise line in an accident and emergency department

Egleston, C V; Kelly, H C; Cope, A

doi:10.1136/bmj.308.6920.31

Cited by 28 publications

(23 citation statements)

References 2 publications

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“…Consistent with other studies of telephone advice nursing that reported follow-through rates of about 75% (Egleston et al, 1994;Poole et al, 1993), Valanis et al we found that 79.9% of the callers reported that they followed all or part of the advice. The factors predicting follow-through with the advice were health status of the patient, helpfulness of the nurse, whether the caller's expectations for collaboration were met, and whether the caller correctly understood the advice given.…”

Section: Discussionsupporting

confidence: 93%

“…The high percentage that reported following all the advice is consistent with reports of followthrough from other studies (Egleston et al, 1994;Poole et al, 1993), and there was considerable variation among sites from a high of 93.5% in Southern California medical offices to a low of 77.5% in the Northwest call center. Although the high follow-through rates reported could reflect a social desirability issue in responses, we do not think this is the case.…”

Section: Discussionsupporting

confidence: 90%

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Predicting Patient Follow-Through on Telephone Nursing Advice

et al. 2007

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Although use of telephone advice nursing services continues to grow, little research has addressed factors that affect crucial call outcomes like follow-through on the advice given. This article describes aspects of the advice call process and examines predictors of caller follow-through, using a conceptual model derived from the literature and the authors' preliminary work. Calls to call centers and medical offices of a large health maintenance organization were taped, then content was coded and matched with caller questionnaire (CQ) data. Out of 1,863 participants, 1,489 reported following all the advice. In the final multivariate predictive model, statistically significant predictors of follow-through were patient health status, caller's rating of nurse helpfulness, and the extent to which caller expectations for collaboration were met and the caller understood the advice given. Results suggest that nurses should receive continuous training on effective communication techniques, and advice nurse performance standards that create barriers to communication should be modified.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Predicting Patient Follow-Through on Telephone Nursing Advice

et al. 2007

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“…Forty five callers (23%) described aspects of the service that they had received that they were dissatisfied about. Examples of the factors that were mentioned as leading to dissatisfaction are given in table 3.…”

Section: Advice-recall and Compliancementioning

confidence: 99%

Patients telephoning A&E for advice: a comparison of expectations and outcomes.

Dale

Crouch

Patel

et al. 1997

Emergency Medicine Journal

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Objective-To investigate the expectations of patients when they phone the accident and emergency (A&E) department, how this relates to the advice they receive, the action they subsequently take, and their satisfaction with the service. Setting-The study was undertaken at an inner city hospital in south east London. Methods-597 calls to the department were documented during the study period, and callers for whom a phone number had been recorded were followed up by structured interviews carried out by a trained interviewer within 72 h of the call. Up to three attempts were made to contact each patient. The interviews were conducted at various times of the day to avoid excluding people with different work or social patterns. Results-The interviewer was able to contact 203 patients within 72 h of their call to the A&E department. Of these 197 (97%) agreed to participate. Almost two thirds stated that when they phoned A&E they anticipated receiving self care advice; 11% expected to be advised to see or contact their general practitioner. Only a quarter of callers stated that they had expected to be told to attend A&E. There was disagreement between the advice that nurses documented as having been given, the advice the caller recalled receiving, and the action the patient subsequently took.Even so, 107 (55%) callers were very satisfied and 62 (32%) were satisfied, while 11 (6%) were dissatisfied with the telephone consultation; 15 (8%) The general public often call accident and emergency (A&E) departments to seek medical information and advice. One recent study found that approximately 50% of the problems discussed with A&E staff over the phone were managed without the patient having to attend; those callers were either redirected to another agency or were given advice over the telephone. ' There is some evidence that the majority of patients who phone an A&E department do so for primary care or nontrauma-related problems.2 A high level of patient satisfaction with A&E telephone advice has been reported.3

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“…Being passed around to different telephones (2) Interpersonal skills of nurse (7) Limitations of telephone advice (10) Uncertainty about what to do (8) Not being advised to attend accident and Identity and position of staff unknown (5) emergency (9) Uncertainty about medical problem (6) Telephone contact, generally (5) Receiving insufficient self care advice (8) Being asked for personal details (4) Diagnosis over the telephone (3) Being unable to speak to doctor (2) Lack of reassurance (1) Nurse did not obtain sufficient information (2) Nurse sounded unprofessional when giving advice (2) Nurse unwilling to access patients previous records (1) Being misunderstood by nurse (2) about all aspects of their visit: reception services, waiting times, quality of the consultation, diagnosis, and treatment: "I was in a lot of pain, and to go to casualty, wait for five hours, to be told they thought I was pregnant and to wait there, when I knew I wasn't-and I wasn't".…”

Section: Sources Of Dissatisfactionmentioning

confidence: 99%