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[Evaluation of pediatric advise asked by telephone in emergency units]
R Carbajal1, P Barthez, J Viala
1Département accueil-urgences, centre hospitalier de Poissy, France.
Insights
Pediatric emergency departments receive many advice calls. Most calls, particularly for infants, do not require immediate physician visits, and callers are satisfied with the guidance provided.
Area of Science:
- Pediatric emergency medicine
- Healthcare communication
- Clinical decision-making
Context:
- Telephone advice is a frequent component of pediatric emergency department (PED) services.
- Understanding the characteristics and outcomes of these calls is crucial for optimizing resource allocation and patient care.
Purpose:
- To analyze the nature of telephone calls for pediatric advice in an emergency department.
- To evaluate the appropriateness of the advice given and caller satisfaction.
Summary:
- A study analyzed 186 pediatric advice calls, finding fever, information requests, rash, and vomiting as common concerns.
- Most calls (67%) did not require urgent physician assessment within six hours.
- Advice was followed in 88% of cases, with 96% caller satisfaction.
Impact:
- Findings highlight the significant role of telephone advice in PEDs.
- The study suggests a need for physician training in telephone management, including communication skills and protocols for frequent pediatric complaints, especially for infants.
Background:
Telephone calls for advice are common in pediatric emergency departments. This study was conducted to determine the nature of these calls and the answers provided.
Methods:
From 24 April through 24 July 1994, all telephone calls requesting pediatric advice in the emergency department of the Poissy Hospital were independently analysed by two pediatricians from forms prospectively filled in for each call by the resident or the attending people who answered the call.
Results:
Of the 239 registered calls, 186 could be analysed. They represented, in number, 15.25% of the children seen at the same emergency department during the study period. Weekend and holiday calls accounted for 35.5% of calls. 7.8% of calls were received from 0.01 am to 8.00 am, 28.7% from 8.01 am to 4.00 pm, and 63.5% from 4.01 pm to 12.00 pm. Thirty-seven percent concerned children under one year of age. The caller was one of the parents in 93% of cases. The four most frequent complaints were fever (26.5%), requests for information (17.2%), rash (12.3%), and vomiting (10.2%). The review of calls by two pediatricians determined that 67% of children did not need to be seen by a physician within six hours; 28% needed to be seen within 6 hours, and 5% needed to be seen within one hour. The advice given was followed in 88% of cases; 96% of callers were satisfied with their calls management.
Conclusions:
Telephone advice constitutes an important part of the activity in the pediatric emergency department. Instructional programs in telephone management are necessary for physicians. These programs should include communication skills and familiarization with protocols concerning the most frequent complaints, especially those regarding children under one year of age.