Background/Purpose: Telephone consultation is essential to the delivery of patient care in the ambulatory care clinics at the Children’s Hospital of Eastern Ontario (CHEO).  Our objective was to quantify and analyze all telephone calls received by the pediatric rheumatology nurses at CHEO.

Methods: As per CHEO policy and procedure, all telephone calls nurses receive are documented on standard forms.  Calls documented by the nursing staff in the Division of Pediatric Rheumatology over a six-month period from Jan 1, 2012 until June 30, 2012 were retrospectively analyzed for selected characteristics.  An incoming call addressing a new concern relating to a specific patient was considered to be the index call.  Index calls and all subsequent documented communications generated by the index call were then examined.  Calls that only confirmed appointments and calls confirming that a message was received were excluded from analysis.

Results: 321 index calls were received during the study period (0.6 calls per clinic hour), generating a total of 780 follow-up calls.  The most frequent patient diagnosis was juvenile idiopathic arthritis (57%) and most patients were 12-18 years old (52%).  79% of calls were placed by the patient’s mother, while only 1% of callers were the patient themselves.  44% of calls lasted 1-5 minutes, 29% lasted 5-10 minutes and 27% lasted more than 10 minutes. The most common reasons for call were concerns relating to rheumatologic condition and medications taken (50%). Large number of calls was related to administrative issues such as requests for appointment change, prescription refills, etc (34%). Pain management was discussed in 29% of all calls. Nurses managed independently 40% of calls; when other health care providers were consulted, the physician was approached in 91% of cases.  Only 8% of index calls resulted in an advanced clinic appointment.

Conclusion: This study provides a descriptive analysis of calls nurses receive in a tertiary care pediatric rheumatology clinic.  While nursing telephone consultation is beneficial in providing inter-disciplinary patient care and in minimizing clinic visits, the associated workload is significant and utilization of this service needs to be optimized, including re-distribution of administrative calls. Teenage patients rarely call themselves and their independence needs to be encouraged.

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« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/telephone-consultation-usage-in-a-pediatric-rheumatology-clinic-considerations-in-optimizing-nursing-resources/