Pediatric residents' telephone triage experience: do parents really follow telephone advice?

A previous study showed that calls received by our continuity clinic residents were similar to those in private practice. However, that study did not address the compliance of the parents to the advice given.

To determine parents' compliance to after-hours telephone advice given by pediatric residents in a continuity clinic.

Advice given during initial telephone contact of 493 after-hours telephone calls was categorized into 3 groups: only telephone advice, appointment the next day, or immediate visit to the emergency department (ED). Follow-up telephone calls were made to all families 3 to 7 days after initial contact to determine compliance with the advice given.

Pediatric resident continuity clinic of a tertiary hospital in Augusta, Georgia.

Children registered in the pediatric resident continuity clinic.

Overall, 412 (83.6%) of 493 caregivers followed the telephone advice that residents gave them. Of the 270 callers only given telephone advice, 244 (90.4%) followed the advice, 15 (5.6%) went to the ED, and 11 (4.1%) made an appointment for the next day. Of the 112 patients instructed to make an appointment, 82 (73.2%) reported at the scheduled time, 18 (16.1%) improved and did not come to the appointment, and 1 (.9%) reported worsened symptoms and went to the ED. When a visit to the ED was recommended, 86 (93.5%) of 92 complied, 2 (2.2%) improved and did not come, 1 (1.1%) had transportation problems, and 3 (3.3%) did not think an ED visit was warranted.

If an after-hours line is used by caregivers, they are more likely to follow the recommendations given by pediatric residents in a tertiary center.