Call-duration and triage decisions in out of hours cooperatives with and without the use of an expert system

Ong, Rob S. G.; Post, Johan; Rooij, Harry van; Haan, J. de

doi:10.1186/1471-2296-9-11

Cited by 16 publications

(12 citation statements)

References 7 publications

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“…Using a DSS could mean a cost reduction for the healthcare sector, as callers are triaged to the optimal level of care (Marklund et al, ). Although calls are slightly longer when a DSS is used (by .7 min), the assessments are more correct (Ong, Post, van Rooij, & de Haan, ).…”

Section: Introductionmentioning

confidence: 99%

Telephone nurses’ use of a decision support system: An observational study

Holmström

Gustafsson²,

Wesström³

et al. 2019

Nursing & Health Sciences

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Telephone nurses give advice and support and make assessments based on verbal communication only. Web-based decision support systems are often used to increase patient safety and make medically correct assessments. The aim of the present this study was to describe factors affecting the use of a decision support system and experiences with this system among telephone nurses in Swedish primary health care. Observations and semistructured interviews were conducted. Six registered nurses with at least 1 year of experience of telephone nursing participated. Field notes and interviews were analyzed by qualitative content analysis. The main findings of the present this study were factors that decrease the decision support system use or promote deviation from decision support system use, factors that are positive for decision support system use and the decision support system complicates the work.Underuse and deviations from decision support systems can be a safety risk, because decisions are based on too little information. Further research with observations of telephone nurses' use of decision support systems is needed to develop both telephone nursing and decision support systems. K E Y W O R D S content analysis, decision support system, participant observation, primary health care, telephone nursing

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Section: Introductionmentioning

confidence: 99%

Telephone nurses’ use of a decision support system: An observational study

Holmström

Gustafsson²,

Wesström³

et al. 2019

Nursing & Health Sciences

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show abstract

“…As shown in the data summary table, this included four literature reviews [19][20][21][22], and one Cochrane review [23]. The quantitative studies ranged from randomised controlled trials and interventions [24,25] to, pre and post-test interventions [26][27][28] to cross sectional and longitudinal studies [29][30][31][32][33][34][35][36] to studies that employed surveys and questionnaires [37,38] and analysis of case records [39,40]. There were three mixed method studies [41][42][43] that drew on existing call centre data and interviews, as well as six qualitative studies.…”

Section: Methodsmentioning

confidence: 99%

“…Although nurses may provide expert advice, in developing countries, for example, services were used as a support tool for village health workers in their day to day care of patients and it was the health worker who was in contact with distant experts [26,27,34,38]. Within developed countries telephone services providing one-off health care advice to patients are usually staffed by experienced registered nurses [23,52], although some are staffed by doctors, or provide a direct referral to a medical specialist [23,33,37,40,45].…”

Section: Cariello F 2000mentioning

confidence: 99%

“…The type of advice provided can be divided into three categories; health promotion [19,25,31,42,43]; assistance in accessing appropriate services and the related symptom triage [43,48]; or reporting, such as reporting back on out-reach work completed or the outbreak of an infectious disease [23,26,33,34,37,43]. Frequency of contact varied in that the telephone service may supplement home visits [28,38,57] or simply be a one-off call.…”

Section: Cariello F 2000mentioning

confidence: 99%

“…Several papers report on the effectiveness of telephone services from the perspective of reducing the workload of general practitioners [23,33,45]. For example, Bunn et al [23] identified that nurses can decrease the workload of general practitioners and the need for medically supported home visits, with 50% of consultations handled by a phone call alone, without any increase in adverse events.…”

Section: Cariello F 2000mentioning

confidence: 99%

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Exploring the role of nurses in after-hours telephone services in regional areas; A scoping review

et al. 2020

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Introduction The management of patients who need chronic and complex care is a focus of attention internationally, brought about by an increase in chronic conditions, requiring significantly more care over longer periods of time. The increase in chronic conditions has placed pressure on health services, financially and physically, bringing about changes in the way care is delivered, with hospital avoidance and home-based care encouraged. In this environment, nurses play an important role in coordinating care across services. This review formed one part of a funded project that explored the nurse navigator role within a proposed 24-hour telephone-call service in one regional area that has a diverse population in terms of cultural identity and geographical location in relation to service access. Aim The review reports on the extant literature on the nurse's role in the provision of afterhours telephone services for patients with chronic and complex conditions. The specific aim was to explore the effectiveness of services for patients in geographically isolated locations. Methods The methodological approach to the review followed the Preferred Reporting System for Meta-Analyses (PRISMA) guidelines. A thematic analysis was used to identify themes with chronic care models underpinning analysis. Results Three themes were identified; nurse-led decision making; consumer profile; and program outcomes. Each theme was divided into two sub-themes. The two sub-themes for decision

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Too Little? Too Much? Primary Care Physicians' Views on US Health Care

Sirovich

Woloshin²,

Schwartz³

2011

Arch Intern Med

129

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Background Some believe that a substantial amount of US health care is unnecessary, suggesting that it would be possible to control costs without rationing effective services. The views of primary care physicians—the frontline of health care delivery—are not known. Methods Between June and December 2009, we conducted a nationally representative mail survey of US primary care physicians (general internal medicine and family practice) randomly selected from the American Medical Association Physician Masterfile (response rate, 70%; n=627). Results Forty-two percent of US primary care physicians believe that patients in their own practice are receiving too much care; only 6% said they were receiving too little. The most important factors physicians identified as leading them to practice more aggressively were malpractice concerns (76%), clinical performance measures (52%), and inadequate time to spend with patients (40%). Physicians also believe that financial incentives encourage aggressive practice: 62% said diagnostic testing would be reduced if it did not generate revenue for medical subspecialists (39% for primary care physicians). Almost all physicians (95%) believe that physicians vary in what they would do for identical patients; 76% are interested in learning how aggressive or conservative their own practice style is compared with that of other physicians in their community. Conclusions Many US primary care physicians believe that their own patients are receiving too much medical care. Malpractice reform, realignment of financial incentives, and more time with patients could remove pressure on physicians to do more than they feel is needed. Physicians are interested in feedback on their practice style, suggesting they may be receptive to change.

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Call-duration and triage decisions in out of hours cooperatives with and without the use of an expert system

Cited by 16 publications

References 7 publications

Telephone nurses’ use of a decision support system: An observational study

Telephone nurses’ use of a decision support system: An observational study

Exploring the role of nurses in after-hours telephone services in regional areas; A scoping review

Too Little? Too Much? Primary Care Physicians' Views on US Health Care

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