HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rapid Responses: Submit a response Rapid Responses: View responses Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hildebrandt, D. E. Articles by Pace, W. D. Search for Related Content PubMed PubMed Citation Articles by Hildebrandt, D. E. Articles by Pace, W. D. Social Bookmarking                      What's this?

Harm Resulting from Inappropriate Telephone Triage in Primary Care

From the Department of Family Medicine, University of Colorado Health Sciences Center at Fitzsimons, Aurora, CO

Correspondence: Corresponding author: David E. Hildebrandt, PhD, Department of Family and Community Medicine, University of Minnesota, 101 Martin Luther King Jr. Drive, Mankato, MN 56001 (E-mail: dhildebrandt{at}bresnan.net)

Purpose: Our objective was to assess and categorize harm occurring to patients who called their physicians’ office after-hours but did not have their call forwarded to the physician because they stated that their call was not an emergency.

Methods: We collected data on 4949 calls handled by our answering service for 1 year in a family medicine residency office in Denver, CO. Of the 2835 after-hours clinical calls, we reviewed all 288 clinical calls that were not forwarded to the "on-call" physician. Complete data on 119 clinical calls included reason for call, frequency of next day appointments, Emergency Department visits, hospital admissions and outcomes. Outcomes were reviewed and coded for harm to the patient by experienced medical errors coders.

Results: When patient calls were not forwarded, 51% had an appointment, 4% an Emergency Department visit, and 2% were admitted to the hospital within 2 weeks. Analysis revealed that 3% suffered harm, and 26% experienced discomfort due to the delay. Although 66% required no intervention, 1% required emergency transport and 4% a medication change.

Conclusions: Harm may occur when patients’ calls are not forwarded to the on-call physician. Although the level of harm is generally temporary and minimal, the potential exists for serious harm to occur. Physicians need to re-evaluate the way they handle after-hours calls.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				B. McKinstry, V. Hammersley, C. Burton, H. Pinnock, R. Elton, J. Dowell, N. Sawdon, D. Heaney, G. Elwyn, and A. Sheikh The quality, safety and content of telephone and face-to-face consultations: a comparative study Qual. Saf. Health Care, August 1, 2010; 19(4): 298 - 303. [Abstract] [Full Text] [PDF]

				E. J. Moskowitz and D. B. Nash The Quality and Safety of Ambulatory Medical Care: Current and Future Prospects American Journal of Medical Quality, August 1, 2007; 22(4): 274 - 288. [PDF]

Rapid Responses: