Table 3.

Examples of After-hours Phone Calls Not Forwarded to On-call Physician

Age and GenderReason for CallNo. of Days before Follow-upHarmed?Patient OutcomeIntervention Due to Phone Call Not Being Forwarded
21 F41 wks OB, leaking fluid3Moderate harm; increased future risk to patientWent to ED with “extreme worsening pain and nausea”/right pyelonephritisEmergency transport to ED
46 FPain in chest, going down left armSame dayPatient discomfortWent to ED and admitted for medication interaction and psychological problemsNo intervention needed
62 MHigh blood sugar, doctor told him to call1Moderate harm; increased future risk to patientWent to office with blood sugar 497, 6 wks polyuria, polydipsia, muscle cramps in lower extremities, ketones present; no prior history of diabetes; sent to ED for fluidsEmergency transport to ED
50 FAnkle injury, fell off horse yesterdaySame dayNo change in patient status.Went to office, inability to bear weight on right ankle; distal fibular fracture, commuted, non-displaced; placed in short leg cast with walking shoeNo intervention needed
16 F8 mo OB, pelvic pain and vaginal infection for 3 mo1Patient discomfortAdmitted to hospital; Cesarean section for acute chorioamnionitis; hospitalized for 4 days postsurgeryED visit made
56 MPlease call5Patient inconvenience; patient discomfortWent to ED with a sore throat, urinary tract infection; medications given to treat infectionED visit made
17 MHigh fever3Patient discomfortWent to office with 3-day history of fever and chills, temperature to 103.5, x-ray shows mild right lower lobe streaky; atypical pneumonia; medications givenNo intervention needed
43 MPlease call, health issue1No change in patient statusWent to office, history of prostate CA 5 years ago; over past 2 years, he has been getting angry at family members and others, because of his moodiness and anger, his wife left 1Embedded Image wks ago, family worried he is depressed and suicidalNo intervention needed
27 FChest pain, hard time breathing2Patient discomfortWent to office with a pre-syncopal episode; set-up for Holter monitorNo intervention needed