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Poots J, Morgan J, Curcuruto M. A Bibliometric Analysis of Telephone Triage Research to 2021 Using VOSviewer. BIOMED RESEARCH INTERNATIONAL 2024; 2024:5583853. [PMID: 38884016 PMCID: PMC11178401 DOI: 10.1155/2024/5583853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/18/2024]
Abstract
Telephone triage services are becoming increasingly commonplace in modern healthcare. Despite this widespread adoption, health researchers and practitioners seeking to understand evidence-based best practice face several challenges. Firstly, the few systematic reviews available yield small sample sizes, suggesting a small amount of research. Secondly, the rapid pace of development of telephone triage technologies means that there may be temporal validity issues with the available research, given some of this research is relatively old. Thirdly, researchers use different terminologies to describe telephone triage, meaning evidence may be more difficult to find than if consistent terminology was used. This bibliometric analysis therefore is aimed at providing a macroscopic overview of telephone triage, to understand the scale and scope of the available evidence (i.e., where, when, and by whom research is conducted), for interested researchers and practitioners. Additionally, it is aimed at quantifying the prevalence of terms used to describe telephone triage, to recommend consistent terminology for future use, and to improve accessibility of research. To address these aims, literature searches using three different key terms: "telephone triage," "remote triage," and "teletriage" were conducted in Scopus and PubMed. Corresponding bibliometric data was visualised and analysed using VOSviewer. This bibliometric review identified 784 papers since the term "telephone triage" first appears in 1980, confirming a paucity of literature in the field. An overview of telephone triage research up to 2021 is provided, which should serve as a useful foundation for future research and application of evidence-based practice. Gaps in telephone triage research are identified, and the use of consistent terminology is encouraged, with the aim of supporting telephone triage researchers in determining research priorities and improving the impact of future studies.
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Affiliation(s)
- Jill Poots
- School of Humanities and Social SciencesLeeds Beckett University, Leeds, England, UK
| | - Jim Morgan
- School of Humanities and Social SciencesLeeds Beckett University, Leeds, England, UK
| | - Matteo Curcuruto
- School of Humanities and Social SciencesLeeds Beckett University, Leeds, England, UK
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Rose DE, Leung LB, McClean M, Nelson KM, Curtis I, Yano EM, Rubenstein LV, Stockdale SE. Associations Between Primary Care Providers and Staff-Reported Access Management Challenges and Patient Perceptions of Access. J Gen Intern Med 2023; 38:2870-2878. [PMID: 37532877 PMCID: PMC10593665 DOI: 10.1007/s11606-023-08172-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 03/13/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND/OBJECTIVE Optimizing patients' access to primary care is critically important but challenging. In a national survey, we asked primary care providers and staff to rate specific care processes as access management challenges and assessed whether clinics with more of these challenges had worse access outcomes. METHODS Study design: Cross sectional. National Primary Care Personnel Survey (NPCPS) (2018) participants included 6210 primary care providers (PCPs) and staff in 813 clinics (19% response rate) and 158,645 of their patients. We linked PCP and staff ratings of access management challenges to veterans' perceived access from 2018-2019 Survey of Healthcare Experiences of Patients-Patient Centered Medical Home (SHEP-PCMH) surveys (35.6% response rate). MAIN MEASURES The NPCPS queried PCPs and staff about access management challenges. The mean overall access challenge score was 28.6, SD 6.0. The SHEP-PCMH access composite asked how often veterans reported always obtaining urgent appointments same/next day; routine appointments when desired and having medical questions answered during office hours. ANALYTIC APPROACH We aggregated PCP and staff responses to clinic level, and use multi-level, multivariate logistic regressions to assess associations between clinic-level access management challenges and patient perceptions of access. We controlled for veteran-, facility-, and area-level characteristics. KEY RESULTS Veterans at clinics with more access management challenges (> 75th percentile) had a lower likelihood of reporting always receiving timely urgent care appointments (AOR: .86, 95% CI: .78-.95); always receiving routine appointments (AOR: .74, 95% CI: .67-.82); and always reporting same- or next-day answers to telephone questions (AOR: .79, 95% CI: .70-.90) compared to veterans receiving care at clinics with fewer (< 25th percentile) challenges. DISCUSSION/CONCLUSION Findings show a strong relationship between higher levels of access management challenges and worse patient perceptions of access. Addressing access management challenges, particularly those associated with call center communication, may be an actionable path for improved patient experience.
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Affiliation(s)
- Danielle E Rose
- VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
| | - Lucinda B Leung
- VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michael McClean
- VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Karin M Nelson
- VA Puget Sound Healthcare System, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | | | - Elizabeth M Yano
- VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Lisa V Rubenstein
- Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Fielding School of Public Health, UCLA, Los Angeles, CA, USA
- RAND Corporation, Santa Monica, CA, USA
| | - Susan E Stockdale
- VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
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Roivainen P, Hoikka MJ, Ala-Kokko TI, Kääriäinen M. Patient satisfaction with telephone care assessment among patients with non-urgent prehospital emergency care issues: A cross-sectional study. Int Emerg Nurs 2021; 59:101070. [PMID: 34592607 DOI: 10.1016/j.ienj.2021.101070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 07/17/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Telephone care assessment (TCA) by a nurse have shown to reduce the number of emergency department (ED) visits and emergency medical services missions (EMS). The present study aimed to describe satisfaction among patients with non-urgent prehospital medical issues that were transferred to TCA instead of receiving EMS. These results could provide a basis for developing the telephone services and emergency care pathways. METHODS This cross-sectional study included 765 patients with non-urgent issues that were transferred to a telephone care assessment, after a risk and urgency assessment by an emergency medical communications operator. One week later, patient satisfaction was evaluated in a structured telephone interview with randomized patients. RESULTS 127 telephone interviews were completed.Most patients (70.9-85.0%) were highly satisfied with the telephone care assessment. In particular,patients who were unsure of the urgency of their own health condition and the need for EMS, were highly satisfied (95.3%). Patients that received EMS after the telephone care assessment were more satisfied than those that received telephone guidance or those directed to other health care services (91.4% vs. 65.5% vs. 67.9%, p = 0.002). CONCLUSION Patients with non-urgent prehospital emergency issues were mainly satisfied with telephone care assessment. In considering ways to reduce the increasing load on emergency medical services, a telephone care assessment could be a good option, without reducing patient satisfaction.
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Affiliation(s)
- P Roivainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - M J Hoikka
- Emergency Medical Services, Kainuu Central Hospital, Sotkamontie 13, 87300 Kajaani, Finland.
| | - T I Ala-Kokko
- Research Group of Surgery, Anaesthesia and Intensive Care Medicine, University of Oulu, Medical Research Center, Division of Intensive Care, Oulu University Hospital, PO Box 21, 90029 Oulu, Finland.
| | - M Kääriäinen
- Faculty of Medicine, Research Unit of Nursing Science and Health Management, University of Oulu, Medical Research Center, Oulu University Hospital, Finland.
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Sands N, Elsom S, Keppich-Arnold S, Henderson K, Thomas PA. Perceptions of crisis care in populations who self-referred to a telephone-based mental health triage service. Int J Ment Health Nurs 2016; 25:136-43. [PMID: 26733103 DOI: 10.1111/inm.12177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/22/2015] [Accepted: 08/31/2015] [Indexed: 11/30/2022]
Abstract
Although psychiatric crises are very common in people with mental illness, little is known about consumer perceptions of mental health crisis care. Given the current emphasis on recovery-oriented approaches, shared decision-making, and partnering with consumers in planning and delivering care, this knowledge gap is significant. Since the late 1990s, access to Australian mental health services has been facilitated by 24/7 telephone-based mental health triage systems, which provide initial psychiatric assessment, referral, support, and advice. A significant proportion of consumers access telephone-based mental health triage services in a state of crisis, but to date, there has been no published studies that specifically report on consumer perceptions on the quality and effectiveness of the care provided by these services. This article reports on a study that investigated consumer perceptions of accessing telephone-based mental health triage services. Seventy-five mental health consumers participated in a telephone interview about their triage service use experience. An eight-item survey designed to measure the responsiveness of mental health services was used for data collection. The findings reported here focus on the qualitative data produced in the study. Consumer participants shared a range of perspectives on telephone-based mental health triage that provide invaluable insights into the needs, expectations, and service use experiences of consumers seeking assistance with a mental health problem. Consumer perceptions of crisis care have important implications for practice. Approaches and interventions identified as important to quality care can be used to inform educational and practice initiatives that promote person-centred, collaborative crisis care.
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Affiliation(s)
- Natisha Sands
- Faculty of Health, Deakin University School of Nursing and Midwifery, Geelong, Australia
| | - Stephen Elsom
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
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O'Cathain A, Knowles E, Turner J, Nicholl J. Acceptability of NHS 111 the telephone service for urgent health care: cross sectional postal survey of users' views. Fam Pract 2014; 31:193-200. [PMID: 24334420 PMCID: PMC3969523 DOI: 10.1093/fampra/cmt078] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In 2010, a new telephone service, NHS 111, was piloted to improve access to urgent care in England. A unique feature is the use of non-clinical call takers who triage calls with computerized decision support and have access to clinical advisors when necessary. Aim. To explore users' acceptability of NHS 111. DESIGN Cross-sectional postal survey. SETTING Four pilot sites in England. METHOD A postal survey of recent users of NHS 111. RESULTS The response rate was 41% (1769/4265), with 49% offering written comments (872/1769). Sixty-five percent indicated the advice given had been very helpful and 28% quite helpful. The majority of respondents (86%) indicated that they fully complied with advice. Seventy-three percent was very satisfied and 19% quite satisfied with the service overall. Users were less satisfied with the relevance of questions asked, and the accuracy and appropriateness of advice given, than with other aspects of the service. Users who were autorouted to NHS 111 from services such as GP out-of-hours services were less satisfied than direct callers. CONCLUSION In pilot services in the first year of operation, NHS 111 appeared to be acceptable to the majority of users. Acceptability could be improved by reassessing the necessity of triage questions used and auditing the accuracy and appropriateness of advice given. User acceptability should be viewed in the context of findings from the wider evaluation, which identified that the NHS 111 pilot services did not improve access to urgent care and indeed increased the use of emergency ambulance services.
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Affiliation(s)
- Alicia O'Cathain
- Medical Care Research Unit, The School of Health and Related Research, University of Sheffield, Sheffield UK
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Locatelli SM, LaVela SL, Talbot ME, Davies ML. How do patients respond when confronted with telephone access barriers to care? Health Expect 2014; 18:2154-63. [PMID: 24612441 DOI: 10.1111/hex.12184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To gain an in-depth understanding of patient barriers to accessing telephone care, subsequent responses to telephone access issues and recommendations for system improvement within a large integrated health-care system. STUDY DESIGN Cross-sectional qualitative focus group study. METHODS One focus group was conducted at each of 17 Veterans Affairs facilities with a total of 123 Veteran users of VA health care. All facilities followed a focus group discussion guide, and purposively sampled patients receiving care at their VA facility in primary and/or specialty care. Focus groups' recordings were sent to the authors' independent evaluation centre, transcribed verbatim and analysed using qualitative content analysis methodology. RESULTS Participants described many issues with the phone system that resulted in delays to care needs being addressed, including difficulty getting someone to answer the phone, out-dated phone directories, frequent disconnections and incorrect transfers. Participants most frequently responded to access issues by doing nothing or waiting to contact at a later time, or seeking unscheduled in-person care in the emergency department or primary care clinic. Participants offered recommendations for improving telephone care, including access to direct extensions, and upgrades to the telephone system. CONCLUSIONS Telephone access issues could result in increased patient harm and/or increased wait times for in-person primary care or emergency services. Periodic evaluation of telephone systems is necessary to ensure telephone systems adequately meet patient needs while using resources efficiently to optimize the delivery of high quality, safe health care.
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Affiliation(s)
- Sara M Locatelli
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs (DVA), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center for Evaluation of Practices and Experiences of Patient-Centered Care (CEPEP), Department of Veterans Affairs (DVA), Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs (DVA), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center for Evaluation of Practices and Experiences of Patient-Centered Care (CEPEP), Department of Veterans Affairs (DVA), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mary E Talbot
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs (DVA), Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Michael L Davies
- Office of Systems Redesign, Veterans Affairs Central Office, Washington, DC, USA
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Sands N, Elsom S, Marangu E, Keppich-Arnold S, Henderson K. Mental health telephone triage: managing psychiatric crisis and emergency. Perspect Psychiatr Care 2013; 49:65-72. [PMID: 23293999 DOI: 10.1111/j.1744-6163.2012.00346.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The study aims to identify and articulate how mental health telephone triage (MHTT) clinicians manage psychiatric crisis and emergency via the telephone. DESIGN AND METHODS An observational design was employed in the study. Wireless headsets were used to observe 197 occasions of MHTT. FINDINGS Clinicians use a range of practical strategies, therapeutic skills, and psychosocial interventions to manage psychiatric crises and emergencies via the telephone. PRACTICE IMPLICATIONS The evidence base for managing psychiatric crisis/emergency in MHTT is minimal. These findings contribute to the MHTT knowledge base and provide evidence-based strategies for high-quality emergency mental health care.
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Affiliation(s)
- Natisha Sands
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
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Purc-Stephenson RJ, Thrasher C. Patient compliance with telephone triage recommendations: a meta-analytic review. PATIENT EDUCATION AND COUNSELING 2012; 87:135-142. [PMID: 22001679 DOI: 10.1016/j.pec.2011.08.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 08/17/2011] [Accepted: 08/26/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To systematically investigate the extent to which patients comply with triage advice from telenurses and to identify factors that potentially influence compliance. METHODS Findings from 13 studies identified through interdisciplinary research databases (1990-2010) were meta-analyzed. Separate pooled analyses compared patients' compliance rates for emergency services and office care (13 outcomes), emergency services and self care (13 outcomes), and self care and office care (12 outcomes). RESULTS Overall patient compliance was 62%, but varied by intensity of care recommended with low compliance rates for advice to see a general practitioner. Reasons for noncompliance include patients reporting to have heard a different disposition, patients' intentions and health beliefs. CONCLUSION Patient compliance to triage recommendations was influenced by the interactive role of patient perceptions and the quality of provider communication, both of which were mediated by access to health services. Further research is needed to clarify whether noncompliance is attributable to poor communication by the nurse or patient misinterpretation. PRACTICE IMPLICATIONS We highlight the need for communication-skills training in a telephone-consultation context that is patient centered, and specifically addresses building active listening and active advising skills and advantages to structuring the call.
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De Coster C, Quan H, Elford R, Li B, Mazzei L, Zimmer S. Follow-through after calling a nurse telephone advice line: a population-based study. Fam Pract 2010; 27:271-8. [PMID: 20215333 DOI: 10.1093/fampra/cmq003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nurse telephone advice (NTA) lines, a major initiative in primary health care reform, provide symptom triage and health information. Compliance studies utilizing database analysis are frequently limited to a defined population, such as children or Emergency Department (ED) users. OBJECTIVES To explore caller characteristics associated with following NTA advice to go to the ED, see a health care professional or self-care for Calgary, Canada (population 1 million). METHODS NTA data were linked with utilization data to assess ED and physician visits following a call. Four nurse advice categories were defined: go to ED, health care provider in 24 hours, health care provider in 72 hours if symptoms persist and self-care. Follow-through was defined based on health care utilization within specified time periods following the call. Logistic regression identified characteristics associated with follow-through of NTA nurse advice; characteristics included age, sex, neighbourhood income, health status, time of call and type of care protocol. RESULTS Follow-through was highest for self-care advice (83.7%), followed by ED advice (52.3%) and then 24-hour advice (43.2%). Lower follow-through on ED or 24-hour advice was associated with age <4 years, and having lower income, and the opposite was true for self-care advice. Patients with a cardiac complaint had the highest odds of following ED advice. Patients with a gastrointestinal or obstetrics/gynaecology/genitourinary complaint were less likely to follow 24-hour advice. Patients with fever were less likely to follow self-care advice. CONCLUSIONS Understanding characteristics associated with lower follow-through may help the NTA service to refine its approaches to clients.
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Affiliation(s)
- Carolyn De Coster
- Data Integration, Measurement and Reporting, Alberta Health Services, Calgary, Alberta.
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Ivatury G, Moore J, Bloch A. A Doctor in Your Pocket: Health Hotlines in Developing Countries. ACTA ACUST UNITED AC 2009. [DOI: 10.1162/itgg.2009.4.1.119] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fallis WM, Silverthorne D, Franklin J, McClement S. Client and Responder Perceptions of a Personal Emergency Response System: Lifeline. Home Health Care Serv Q 2007; 26:1-21. [PMID: 17804350 DOI: 10.1300/j027v26n03_01] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A mixed methodology mail survey was used to gauge level of customer satisfaction with, and identify issues that may help improve, personal emergency response system service delivery. A total of 1,236 surveys were mailed out to subscribers of Victoria Lifeline (Canada; n = 618) and their designated responders (n = 618). Overall response rate was 50%. Significant predictors of subscriber and responder satisfaction were satisfaction with the service during an emergency and whether expectations of service were met. In addition, for responders, customer service also predicted satisfaction. Thematic analysis of subscriber and responder comments identified the need for improvement in several areas: equipment, cost of the service, training sessions for users, and communication between subscribers and service providers. Although more than 95% of subscribers and responders were satisfied with the service, the findings provide direction to personal emergency response service providers about ways in which their product and service delivery might be enhanced, and underscore the need for research examining the impacts of response systems on family caregivers and public policy regarding community care solutions.
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Affiliation(s)
- Wendy M Fallis
- Victoria General Hospital/University of Manitoba, Clinical Institute of Applied Research and Education, 2340 Pembina Hwy, Winnipeg, MB, R3T 2E8.
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