“I wz wondering‐uhm couldraiduhmeffect the brain permanently d'y know?”: Some observations on the intersection of speaking and writing in calls to a poison control center

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Abstract
Little is known about the interactional or bureaucratic contexts in which writing and speaking occur simultaneously. This study focuses on how written records are created during calls to a Poison Control Center. Analysis of the calls reveals that keeping written records extends the length of call processing time by an average of 1.5 minutes, representing a barrier to handling new calls promptly. In addition, the use of a pre‐coded data entry form coupled with an emphasis on completeness of written records can lead to biased and inaccurate data recording. The majority of calls (79%) contained a problem description that related the teller to the events reported. Diagnostic recommendations were offered an average of 2.5 minutes after the problem statement. Between 11% and 50% of the questions asked during this time were not clinically relevant. It was hypothesized that these questions were asked to avoid premature termination once callers obtained problem relevant information. No evidence was found to suggest that completeness was compromised when clinically relevant problems were solved first.