Examining Telephone Calls in Ambulatory Oncology

Abstract

Purpose: A large component of ambulatory oncology practice is management of telephone calls placed to and from the practice between outpatient appointments. However, scant information is available in the literature concerning oncology practice telephone calls. The specific aims of this study were to define telephone call volume and distribution in an active ambulatory oncology practice, describe the callers and reasons for the telephone calls, and examine any differences in call volume by practice characteristics.Methods: A descriptive retrospective design was used to analyze medical oncology and hematology telephone calls in a 4-month period. Two investigator-developed tools were validated and used to collect data on telephone call content and patient demographics. Results:The sample included 5,283 telephone calls to or from 1,486 different individuals. Individuals making and/or receiving more than one telephone call in the study period represented 56% of the telephone calls. For every 10 scheduled clinic appointments, seven telephone calls were received or made. The volume of telephone calls was significantly higher on Mondays and in the mornings. The reasons for high-volume telephone calls by diagnosis and frequency were identified, with 30% of telephone calls involving multiple reasons. Conclusion:The data demonstrate the impact of telephone calls on ambulatory oncology practice and highlight the complex and highly variable actions required to manage the telephone calls. The findings confirm and document specific practice patterns and identify subgroups that target repeat telephone calls as an area for improvement.

Attributes of Advanced Practice Registered Nurse Care Coordination for Children With Medical Complexity

“…Retrospective review of 2,628 care coordination episodes conducted by telehealth for 27 CMC during a consecutive three-year time period indicated the majority of episodes were initiated by parents, and the primary reason for initiating an episode was acute and chronic condition management. This finding is similar to Flannery, Phillips & Lyons (2009) prospective review of outpatient oncology telephone calls, answered by registered nurses and APRNs utilizing guidelines-based management and care coordination. Over half the calls were initiated by patients or families and the majority were related to condition management (Flannery, Phillips, & Lyons, 2009).…”

“…This finding is similar to Flannery, Phillips & Lyons (2009) prospective review of outpatient oncology telephone calls, answered by registered nurses and APRNs utilizing guidelines-based management and care coordination. Over half the calls were initiated by patients or families and the majority were related to condition management (Flannery, Phillips, & Lyons, 2009). …”

Ambulatory Oncology Nurses Making the Right Call: Assessment and Education in Telephone Triage Practices

“…At the authors' institution, this initiative was intended to identify the educational needs of the RNs and design strategies to educate and improve their telephone triage skills. Flannery, Phillips, and Lyons (2009) noted that RNs can help prevent symptoms from becoming unmanageable and possibly avoid unnecessary and costly visits to emergency departments by patients, thereby eliminating the risk for hospital-acquired infections. Protocols guide nurses to conduct a standardized assessment for the specific symptom and triage symptom management to the appropriate level of care (Stacey, Bak-ker, Green, Zanchetta, & Conlon, 2007).…”

Nurse Telephone Follow-up Post Initial Chemotherapy: A Quality Improvement Project

“…The most frequent reason a patient calls a cancer clinic is to report symptoms or clarify questions about plan of care or treatment (Flannery, 2009). After returning home from the clinic, many patients and family members find themselves struggling to remember all the information reviewed throughout the treatment process along with symptoms to monitor.…”

“…In a descriptive retrospective study conducted by Flannery, Phillips, and Lyons (2009) (2010) examined the effect of telephone follow-up on adherence to a diabetes therapeutic regimen. Random sampling, along with screening, was utilized to obtain a sample size of 60 patients with a diagnosis of type 2 diabetes who attended the Iranian Diabetes Society.…”