Emergency department telephone advice

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Abstract
Objective: To evaluate telephone advice given in an emergency department. Design: Prospective, observational study. Setting: A community‐based emergency department in a semi‐ruraVouter metropolitan setting, between August and November 1995. Participants: All people telephoning the emergency department for medical advice. Methods: Details of all calls, callers and patients were recorded. Within 72 hours, a follow‐up call was initiated seeking replies to a series of standardised questions. Main outcome measures: Number, timing and duration of calls; appropriateness of the advice given; compliance with the advice; and callers' satisfaction with the service. Results: Over the four‐month period, 1682 calls were received, 58% between 4pm and midnight. There were 33 telephone calls per 100 emergency department attendances. The mean call duration was 3.9 minutes (range, 0.25‐25 minutes); 49% of patients were less than 14 years old, and 72% of callers phoned because of spontaneous illness. The advice given was considered inappropriate in only 1.4% of calls. Follow‐up calls were made to 1132 people (67%), revealing a non‐compliance rate of only 6.9% and a high level of caller satisfaction, with 99% of callers affirming a need for such a service. Conclusions: The provision of telephone advice by emergency department staff is rated highly by the community and compliance with the advice is strong. Paediatric problems, arising as a result of spontaneous illness, predominate and there is a large bias towards after‐hours use of the service. Experienced staff provide better advice.