[Pediatric telephone advice in the emergency department]

To describe the activity of telephone advice in a pediatric emergency department and assess the influencing factors to improve quality of care.

Descriptive study about all the anonymous telephone calls received on the direct line of the pediatric emergency room of Le Havre hospital, from 25 January to 25 July 2002, and all the advices given by a doctor or a nurse.

The mean daily call frequency was 2.15 (0-12) with 586 calls during the 6 months period and the mean call duration was 3 min (1-20). Parents took telephone advices for: fever (27%), digestive troubles (22%), and trauma (14%). We found no difference concerning symptoms according to season. The rush hours were, on a bimodal graph, 0-1 am and 8-9 pm, paralleling the rush activity of consultation in pediatric emergency room. The heavy days for phone advices during the week were Tuesday and Wednesday. We found no correlation between heavy days of week and phone call duration. Thirty percent of cases did not need any advice because the asks were only an orientation advice. Advice to go to our emergency department was done in 11% of orientation advice. The call duration was significantly longer for: (1) calls including several symptoms or griefs, (2) calls given by a nurse; (3) calls taking place during hours of lowest activity in the emergency room (between 6 and 12 am), (4) calls including advice about medication or diet; (5) calls for counselling an orientation other than medical establishment.

Our assessment of telephone call advices represented the first step to improve the quality of answer to families. Next step will be written protocols to answer more adequately to main griefs and symptoms that lead families to search for phone counselling.