Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial

Abstract

14 492 calls were received during the specified times in the trial year (7308 in the control arm and 7184 in the intervention arm) concerning 10 134 patients (10.4% of the registered population). There were no substantial differences in the age and sex of patients in the intervention and control groups, though male patients were underrepresented overall. Reasons for calling the service were consistent with previous studies. Nurses managed 49.8% of calls during intervention periods without referral to a general practitioner. A 69% reduction in telephone advice from a general practitioner, together with a 38% reduction in patient attendance at primary care centres and a 23% reduction in home visits was observed during intervention periods. Statistical equivalence was observed in the number of deaths within seven days, in the number of emergency hospital admissions, and in the number of attendances at accident and emergency departments. Conclusions Nurse telephone consultation produced substantial changes in call management, reducing overall workload of general practitioners by 50% while allowing callers faster access to health information and advice. It was not associated with an increase in the number of adverse events. This model of out of hours primary care is safe and effective.

Design and Implementation of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

“…NTLs are also beneficial in that they reduce strain on the HCS, offer high levels of patient satisfaction, and serve as a safe, efficient, and cost-effective method of information dissemination. [19][20][21][22][23][24] Benefits can also be seen in reduced travel costs, reduced time away from school/work, and reduced childcare expenses. 17 …”

Out-of-hours emergency dental services — development of one possible local solution

“…[11][12][13] Recent studies have reported results of randomised controlled trials of nurse telephone triage in out-of-hours primary medical care. 14,15 In one trial, nurse triage reduced GP workload by 50% and concluded that nurse telephone consultation, supported by decision support software, was as safe and effective as the standard care provided by a GP co-operative. 15 …”

HealthConnect: a trial of an after-hours telephone triage service

“…In the UK, a randomised control trial has found telephone triage to be associated with reduced demand for general practice services while providing the same outcomes as usual after-hours care (Lattimer et al 1998), and an overview of services of this kind has suggested that they can reduce growing demand for face-to-face GP services in the after-hours period (Munro et al 2000). Neither study found an impact on the demand for services from emergency departments.…”