Impact of a general practitioners’ strike and of terrorist attacks on a call centre

Orsini, C.; Grave, M.; Linval, F.; Akodad, Hayatte; Goix, Laurent; Adnet, Frédéric; Lapostolle, Frédéric

doi:10.1097/mej.0000000000000436

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…Regarding the RFE, our results were globally similar to other European settings [13]. Organizational factors, such as workload, are known to be negatively associated with the quality of a given procedure [14, 15] and should be anticipated to enhance the reliability of a given system. Our study suggests that only triage assistant-linked factors affect the medical reporting.…”

Section: Discussionsupporting

confidence: 82%

Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France

Heidet¹,

Canouï‐Poitrine²,

Revaux³

et al. 2019

BMC Health Serv Res

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Background In France, general practitioners (GPs) perform out-of-hours home visits (OOH-HVs) after physician-led telephone triage at the emergency call centre. The quality of a systematic physician-led triage has not been determined in France and may affect the efficiency of the OOH-HV process. The objectives of this study were first, to evaluate the quality of reporting in the electronic patient’s file after such triage and second, to analyse the factors associated with altered reporting. Methods Cross-sectional study in a French urban emergency call centre (district of Paris area) from January to December 2015. For a random selection of 30 days, data were collected from electronic medical files that ended with an OOH-HV decision. Missing key quality criteria (medical interrogation, diagnostic hypothesis or ruled-out severity criteria) were analysed by univariate then multivariate logistic regression, adjusted on patient, temporal and organizational data. Results Among 10,284 OOH-HVs performed in 2015, 748 medical files were selected. Reasons for the encounter were digestive tract symptoms (22%), fever (19%), ear nose and throat symptoms, and cardiovascular and respiratory problems (6% each). Medical interrogation was not reported in 2% of files ( n = 16/748) and a diagnostic hypothesis in 58% ( n = 432/748); ruled-out severity criteria were not reported in 60% ( n = 449/748). On multivariate analysis, altered reporting was related to the work overload of triage assistants (number of incoming calls, call duration, telephone occupation rate; p < 0.03). Conclusion In the electronic files of patients requiring an OOH-HV by a GP in a French urban area, quality in medical reporting appeared to depend on organizational factors only, especially the triage assistants-related work factors. Corrective measures are needed to ensure good quality of triage and care. Electronic supplementary material The online version of this article (10.1186/s12913-019-4350-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 82%

Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France

Heidet¹,

Canouï‐Poitrine²,

Revaux³

et al. 2019

BMC Health Serv Res

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“…Finally, and a study that stands alone to all others here, Reuter, Orsini, Grave, Linval, Akodad, Goix, Adnet and Lapostolle 58 examined the impact of a 1 day GP strike on 13th November 2015 (a day which coincided with a terrorist attack in Paris) on an emergency call centre. While the GP strike resulted in an increased number of calls related to patient medical files, emergency calls did not increase substantially.…”

Section: Resultsmentioning

confidence: 99%

The impact of strike action on healthcare delivery: A scoping review

Essex

Ahmed

Elliott

et al. 2022

Health Planning & Management

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Background: Strike action carried out by healthcare workers raises a range of ethical issues.Most fundamentally, as a strike is designed to disrupt, it has the potential to impact patient outcomes and healthcare delivery. This paper synthesises and analyses the empirical literature that details the impact of strike action on healthcare delivery.Methods: A systematic scoping review was utilised to examine the extent, range and nature of research activity. Embase, Medline, CINAHL, Bioethicsline, EconLit and Web of Science were searched, yielding 5644 results. Papers were included if they examined the impact that strike action had on healthcare delivery (i.e., admissions, presentation). After screening 43 papers met inclusion criteria.Results: Nineteen studies explored presentations to emergency or admissions to hospital. Both dropped dramatically when comparing non-strike to strike periods. Ten studies examined length of stay in hospital and waiting times. No relation to either was found in relation to strike action, with some studies showing that wait times decreased. Nine studies examined the impact of strike action in facilities that were not on strike, but impacted by nearby strike action and the impact that strike action had on treatment seeking. Hospitals dealing with these upstream impacts often saw increase in presentations at hospitals, but results relates to treatment seeking during strike action were mixed. Conclusion: Strike action can have a substantial impact on the delivery of healthcare, but this impact is not felt uniformly across services. While many services are disrupted, a number are not, with several studies reporting increased efficiency.

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“…ou une canicule, mais pas toujours [4]. Parfois, les causes en sont toutes autres, comme des manifestations sportives ou d'autres événements [5,6]. Cette modification de l'activité du Samu-Centre 15 influe évidemment sur la qualité de la prestation proposée.…”

Section: Discussionunclassified

Corrélation entre la qualité de la réponse aux appels d’un Samu-Centre 15 et les effectifs d’assistants de régulation médicale — Étude QRAARM

Goix

Pétrovic

Chanzy

et al. 2018

Ann. Fr. Med. Urgence

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Introduction : Le taux d’occupation des lignes téléphoniques d’un Samu-Centre 15 conditionne la fluidité de la gestion des appels et donc sa capacité de répondre à l’urgence. La disponibilité des assistants de régulation médicale (ARM) et des médecins régulateurs est déterminante. Nous nous sommes interrogés sur l’impact du nombre d’ARM sur la prise en charge des appels d’un Samu-Centre 15. Méthodes : Le taux d’appels raccrochés (par l’appelant) après 15 secondes a été retenu comme critère de jugement principal. Il a été analysé en fonction de l’effectif « réel » d’ARM. L’effectif théorique d’ARM a été pris comme référence. Deux analyses ont été réalisées, la première portant sur 672 périodes d’un quart d’heure de la semaine 51 de l’année 2016 (en période d’épidémie de grippe) et la seconde sur 3 624 périodes d’une heure sur les cinq premiers mois de l’année 2017. Résultats : Sur la première période, le nombre médian d’appels raccrochés après 15 secondes était de 1 (0–3) par quart d’heure. Il variait de 0 (0–1) à 3 (1–5) selon l’effectif d’ARM auquel il était parfaitement inversement corrélé (p < 0,001). Sur la seconde période, le nombre médian d’appels raccrochés était de 4 (1–8) par heure. Il variait de 2 (1–6) à 10 (6–16) selon l’effectif d’ARM auquel il était parfaitement inversement corrélé (p < 0,001). Conclusion : Le taux d’appels raccrochés après 15 secondes était parfaitement corrélé à l’effectif (plus précisément au sous-effectif) d’ARM. Sur une année, le nombre estimé d’appels perdus ainsi était proche de 50 000 ! Prendre en considération l’effectif des ARM est une nécessité absolue.

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Impact of a general practitioners’ strike and of terrorist attacks on a call centre

Cited by 10 publications

References 10 publications

Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France

Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France

The impact of strike action on healthcare delivery: A scoping review

Corrélation entre la qualité de la réponse aux appels d’un Samu-Centre 15 et les effectifs d’assistants de régulation médicale — Étude QRAARM

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