Emergency department referrals from a provincial medical call centre: Is it more than just 1-800-go-to-emerg?

Abstract

ObjectiveHealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system.MethodsA list of callers referred from HealthLine to Saskatoon EDs from January 1, 2014, to March 31, 2014 was obtained. This list was cross-referenced with Saskatoon Health Region registration data to determine which of those callers had been registered in one of the three Saskatoon EDs within 48 hours of the original call.ResultsDuring the 90-day time period in question, 707/3,938 (17.9%) of callers were referred by HealthLine to the ED. Out of those referred, 601 were identifiable and 358 attended the ED. Hospital charts were pulled for full data extraction and analysis of the 276 who met inclusion criteria. Of those who presented to the ED and met inclusion criteria, 60% had investigations performed while 66% received some form of treatment. The overall admission rate for the patient population studied was 12.0% v. 16% for non-referred patients. Referred pediatric patients had fewer investigations and treatments with a lower admission rate compared with the adult patients.ConclusionThe Saskatchewan HealthLine is doing an effective job at directing callers both to and away from EDs in Saskatoon and not overburdening our local EDs with unnecessary referrals.

Strength in the gap: A rapid review of principles and practices for urgent care centres

“… 23 Community services like HealthLine, a provincial medical call centre, have been shown to positively affect patient urgent care decisions and therefore need to be both consulted and informed regarding UCCs. 52 …”

The effectiveness of tele-triage during the COVID-19 pandemic: A systematic review and narrative synthesis

“…Other studies showed different results regarding the effect of tele-triage systems on the emergency units so some studies suggested that tele-triage interventions led to a moderate to significant decline in non-emergency visits and re-hospitalization, specifically for older and chronic patients and parents with young children. 17 , 18 Still, Turbitt et al stated that patients referred to ED through tele-triage could be potentially managed outside the emergency environment as well. 19 Therefore, tele-triage systems in pandemic situations can be effective in preventing unnecessary visits of patients to ED.…”

“…Some studies showed that tele-triage interventions lead to a significant decline in postponing emergency visits and re-hospitalization, especially in older and chronic patients and parents with young children. 17 , 18 Moreover, patients have reported high levels of acceptance and increased satisfaction with tele-triage services. Meanwhile, one study indicated that a large number of the patients referred to ED through tele-triage could have been managed outside the emergency environment as well.…”

Virtual Triage and Teletriage in Rural Canada and Australia

“…Some published studies demonstrate that teletriage interventions have moderate to substantial reductions of deferrals in ED visits and hospital readmissions, especially for older and chronic patients and parents with young children. 21,[26][27][28] This effect was further demonstrated when teletriage services offered multiple layers of care, such as integrating virtual assessments and appointments by physicians or nurse practitioners. 20 On the contrary, some studies show that a high number of patients with lower urgency conditions are still advised to attend by teletriage professionals.…”

“…17,21 This shows that teletriage systems can be effective at deferring patients away from the ED, but there is room for further improvement. 28 Further research is needed to understand the overall impact of teletriage on EDs and the economic impacts on healthcare systems as a whole.…”