[Telephone triage performed by emergency room physicians]

Area of Science:

• Emergency Medicine
• Pediatrics
• Health Services Research

Context:

• Pediatric emergency departments (PEDs) face high patient volumes.
• Telephone triage offers a potential solution for managing patient flow and providing initial medical advice.
• Assessing the efficacy and safety of physician-performed telephone consultations is crucial for optimizing emergency care.

Purpose:

• To evaluate the applicability and utility of telephone triage conducted by physicians in a pediatric emergency department.
• To analyze call volume, reasons for consultation, adherence to medical advice, and patient outcomes.
• To determine parent satisfaction with telephone consultation services.

Summary:

• A review of 2,560 telephone consultations in a PED revealed that 82% were resolved with home care instructions.
• Physician-led telephone triage successfully advised 274 patients to attend the PED, with a significantly lower admission rate (0.9%) compared to direct referrals (7.2%).
• Over 90% of families reported satisfaction, and telephone consultations potentially averted 115 visits per month.

Impact:

• Physician-performed telephone triage in PEDs is a safe and valuable tool for patient management.
• Implementing structured training programs and efficient answering systems enhances the utility of telephone consultations.
• High parental satisfaction and reduced unnecessary ED visits demonstrate the positive impact on healthcare resource utilization.