TY - JOUR T1 - Harm Resulting from Inappropriate Telephone Triage in Primary Care JF - The Journal of the American Board of Family Medicine JO - J Am Board Fam Med SP - 437 LP - 442 DO - 10.3122/jabfm.19.5.437 VL - 19 IS - 5 AU - David E. Hildebrandt AU - John M. Westfall AU - Douglas H. Fernald AU - Wilson D. Pace Y1 - 2006/09/01 UR - http://www.jabfm.org/content/19/5/437.abstract N2 - 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. ER -