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Eslami Jahromi M, Ayatollahi H, Ebrazeh A. Covid-19 hotlines, helplines and call centers: a systematic review of characteristics, challenges and lessons learned. BMC Public Health 2024; 24:1191. [PMID: 38679706 PMCID: PMC11056073 DOI: 10.1186/s12889-024-18702-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/23/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND During the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic. METHODS PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist. RESULTS In total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 (n = 19). Providing psychological support (n = 23), reliable information about Covid-19 (n = 10), healthcare advices about Covid-19 (n = 8), and triage (n = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators. CONCLUSION According to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.
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Affiliation(s)
- Maryam Eslami Jahromi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, No. 4, Rashid Yasemi St, Vali-Asr St, Tehran, 1996713883, Iran.
| | - Ali Ebrazeh
- Department of Public Health, School of Public Health, Qom University of Medical Sciences, Qom, Iran
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Arafa M, El Ansari W, Qasem F, Al Ansari A, Al Dosari MAA, Mukhtar K, Alhabash MA, Awad K, Al Rumaihi K. Reinventing Patient Support and Continuity of Care Using Innovative Physician-staffed Hotline: More than 60,000 Patients Served Across 15 Medical and Surgical Specialties During the First Wave of COVID-19 Lockdown in Qatar. J Med Syst 2023; 47:77. [PMID: 37466754 PMCID: PMC10356882 DOI: 10.1007/s10916-023-01973-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] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
Rising disease prevalence early during the COVID-19 pandemic in the State of Qatar led to stoppage of all non-emergency health care services. To maintain continuity of care and information exchanges for non-emergency patients, a physician-operated telephone hotline was set up that involved triage followed by immediate consultation with a specialized physician. We describe the initiation and evaluate the operations of the Urgent Consultation Centre (UCC) hotline manned by 150 physicians and aimed at urgent non-life-threatening consultations at Hamad Medical Corporation, the public health provider in Qatar. UCC established a hotline to triage inbound patient calls related to 15 medical and surgical specialties. For calls between April-August 2020, we describe call volume, distribution by specialty, outcomes, performance of UCC team, as well as demographics of callers. During the study period, UCC received 60229 calls (average 394 calls/day) from Qatari nationals (38%) and expatriates (62%). Maximum total daily calls peaked at 1670 calls on June 14, 2020. Call volumes were the highest from 9 AM to 2 PM. Response rate varied from 89% to 100%. After an initial telephone triage, calls were most often related to and thus directed to internal medicine (24.61%) and geriatrics (11.97%), while the least percentage of calls were for pain management and oncology/hematology (around 2% for each). By outcome of consultation, repeat prescriptions were provided for 60% of calls, new prescriptions (15%), while referrals were to outpatient department (17%), emergency department/pediatric emergency center (5%), and primary health care centres (3%). We conclude that during a pandemic, physician-staffed telephone hotline is feasible and can be employed in innovative ways to conserve medical resources, maintain continuity of care, and serve patients requiring urgent care.
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Affiliation(s)
- Mohamed Arafa
- Urology Department, Hamad Medical Corporation, Doha, Qatar
- Andrology Department, Cairo University, Cairo, Egypt
- Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Walid El Ansari
- Weill Cornell Medicine - Qatar, Doha, Qatar.
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
- College of Medicine, Qatar University, Doha, Qatar.
| | - Fadi Qasem
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Abdulla Al Ansari
- Urology Department, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine - Qatar, Doha, Qatar
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | | | - Khalid Mukhtar
- Department of Orthopedics, Hamad Medical Corporation, Doha, Qatar
| | | | - Khalid Awad
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Al Rumaihi
- Urology Department, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine - Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
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Kumar K, Ratnakumar P, Ricci P, Al-Zubaidy M, Srikanthan K, Agrawal S, Ahmedani I, Baxter I, Monem E, Coleman M, Elkin SL, Kon OM, Mallia P, Meghji J, Ross C, Russell GK. Recovering from COVID-19: lessons learnt from an intensive secondary care follow-up service. Future Healthc J 2022; 9:335-342. [PMID: 36561827 PMCID: PMC9761447 DOI: 10.7861/fhj.2021-0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In response to the first COVID-19 surge in 2020, secondary care outpatient services were rapidly reconfigured to provide specialist review for disease sequelae. At our institution, comprising hospitals across three sites in London, we initially implemented a COVID-19 follow-up pathway that was in line with expert opinion at the time but more intensive than initial clinical guidelines suggested. We retrospectively evaluated the resource requirements for this service, which supported 526 patients from April 2020 to October 2020. At the 6-week review, 193/403 (47.9%) patients reported persistent breathlessness, 46/336 (13.7%) desaturated on exercise testing, 167/403 (41.4%) were discharged from COVID-19-related secondary care services and 190/403 (47.1%) needed 12-week follow-up. At the 12-week review, 113/309 (36.6%) patients reported persistent breathlessness, 30/266 (11.3%) desaturated on exercise testing and 150/309 (48.5%) were discharged from COVID-19-related secondary care services. Referrals were generated to multiple medical specialties, particularly respiratory subspecialties. Our analysis allowed us to justify rationalising and streamlining provisions for subsequent COVID-19 waves while reassured that opportunities for early intervention were not being missed.
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Affiliation(s)
- Kartik Kumar
- ASt Mary's Hospital, London, UK and National Institute for Health and Care Research Imperial Biomedical Research Centre clinical research fellow in respiratory medicine, Imperial College London, London, UK
| | - Prashanthi Ratnakumar
- BSt Mary's Hospital, London, UK and clinical research fellow in respiratory medicine and lung cancer, Imperial College London, London, UK
| | | | | | | | | | | | | | - Enrique Monem
- DImperial College London Faculty of Medicine, London, UK
| | - Meg Coleman
- GSt Mary's Hospital, London, UK and honorary clinical senior lecturer, Imperial College London, London, UK
| | - Sarah L Elkin
- HSt Mary's Hospital, London, UK and honorary clinical senior lecturer, Imperial College London, London, UK
| | - Onn Min Kon
- ISt Mary's Hospital, London, UK and professor of respiratory medicine, Imperial College London, London, UK
| | - Patrick Mallia
- JSt Mary's Hospital, London, UK and clinical senior lecturer, Imperial College London, London, UK
| | - Jamilah Meghji
- KSt Mary's Hospital, London, UK and Medical Research Council skills development fellow, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Clare Ross
- LSt Mary's Hospital, London, UK and honorary clinical senior lecturer, Imperial College London, London, UK
| | - Georgina K Russell
- MSt Mary's Hospital, London, UK,Address for correspondence: Dr Georgina K Russell, Department of Respiratory Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK.
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Matenge S, Sturgiss E, Desborough J, Hall Dykgraaf S, Dut G, Kidd M. Ensuring the continuation of routine primary care during the COVID-19 pandemic: a review of the international literature. Fam Pract 2022; 39:747-761. [PMID: 34611708 PMCID: PMC8515263 DOI: 10.1093/fampra/cmab115] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in the diversion of health resources away from routine primary care delivery. This disruption of health services has necessitated new approaches to providing care to ensure continuity. OBJECTIVES To summarize changes to the provision of routine primary care services during the pandemic. METHODS Rapid literature review using PubMed/MEDLINE, SCOPUS, and Cochrane. Eligible studies were based in primary care and described practice-level changes in the provision of routine care in response to COVID-19. Relevant data addressing changes to routine primary care delivery, impact on primary care functions and challenges experienced in adjusting to new approaches to providing care, were obtained from included studies. A narrative summary was guided by Burns et al.'s framework for primary care provision in disasters. RESULTS Seventeen of 1,699 identified papers were included. Studies reported on telehealth use and public health measures to maintain safe access to routine primary care, including providing COVID-19 screening, and establishing dedicated care pathways for non-COVID and COVID-related issues. Acute and urgent care were prioritized, causing disruptions to chronic disease management and preventive care. Challenges included telehealth use including disparities in access and practical difficulties in assessing patients, personal protective equipment shortages, and financial solvency of medical practices. CONCLUSIONS Substantial disruptions to routine primary care occurred due to the COVID-19 pandemic. Primary care practices' rapid adaptation, often with limited resources and support, demonstrates agility and innovative capacity. Findings underscore the need for timely guidance and support from authorities to optimize the provision of comprehensive routine care during pandemics.
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Affiliation(s)
- Sethunya Matenge
- Department of Health Services Research and Policy, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Elizabeth Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Sally Hall Dykgraaf
- Rural Clinical School, ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Garang Dut
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Michael Kidd
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,Australian Government Department of Health, Canberra, ACT, Australia.,Department of Family and Community Medicine, The University of Toronto, Toronto, Canada.,Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia.,Southgate Institute for Equity, Health and Society, Flinders University, Adelaide, SA, Australia
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Kumar K, Groom K, Martin L, Russell GK, Elkin SL. Educational opportunities for postgraduate medical trainees during the COVID-19 pandemic: deriving value from old, new and emerging ways of learning. Postgrad Med J 2022; 98:328-330. [PMID: 34344700 PMCID: PMC9046751 DOI: 10.1136/postgradmedj-2021-140603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/11/2021] [Indexed: 01/09/2023]
Abstract
The COVID-19 pandemic has had a significant impact on postgraduate medical training across all specialties. Although some traditional learning opportunities have been curtailed, there have been numerous examples of highly valuable educational experiences that have arisen during this time. Here, from a trainee perspective, we consider the educational merits of the re-emergence of 'firm-based' teams, new online learning opportunities, use of digital technologies and the rise of telephone clinics and new COVID-19 clinical services. As health services continue to recover from surges in COVID-19 cases, it is important to reflect on and recognise the value of these educational experiences so that helpful elements can be retained and embedded into training programmes for the benefit of both trainees and patients.
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Affiliation(s)
- Kartik Kumar
- Department of Respiratory Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Katherine Groom
- Department of Respiratory Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Laura Martin
- Department of Respiratory Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Georgina K Russell
- Department of Respiratory Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Sarah L Elkin
- Department of Respiratory Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
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Mallia P, Meghji J, Wong B, Kumar K, Pilkington V, Chhabra S, Russell B, Chen J, Srikanthan K, Park M, Owles H, Liew F, Alcada J, Martin L, Coleman M, Elkin S, Ross C, Agrawal S, Gardiner T, Bell A, White A, Hampson D, Vithlani G, Manalan K, Bramer S, Martin Segura A, Kucheria A, Ratnakumar P, Sheeka A, Anandan L, Copley S, Russell G, Bloom CI, Kon OM. Symptomatic, biochemical and radiographic recovery in patients with COVID-19. BMJ Open Respir Res 2021; 8:8/1/e000908. [PMID: 33827856 PMCID: PMC8029037 DOI: 10.1136/bmjresp-2021-000908] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/12/2022] Open
Abstract
Background The symptoms, radiography, biochemistry and healthcare utilisation of patients with COVID-19 following discharge from hospital have not been well described. Methods Retrospective analysis of 401 adult patients attending a clinic following an index hospital admission or emergency department attendance with COVID-19. Regression models were used to assess the association between characteristics and persistent abnormal chest radiographs or breathlessness. Results 75.1% of patients were symptomatic at a median of 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. 18.5% of patients had unscheduled healthcare visits in the 30 days post discharge. Conclusions Patients with COVID-19 experience persistent symptoms and abnormal blood biomarkers with a gradual resolution of radiological abnormalities over time. These findings can inform patients and clinicians about expected recovery times and plan services for follow-up of patients with COVID-19.
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Affiliation(s)
- Patrick Mallia
- Imperial College Healthcare NHS Trust, London, UK .,National Heart and Lung Institute, Imperial College, London, UK
| | - Jamilah Meghji
- Imperial College Healthcare NHS Trust, London, UK.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Brandon Wong
- Imperial College Healthcare NHS Trust, London, UK
| | - Kartik Kumar
- Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Ben Russell
- Imperial College Healthcare NHS Trust, London, UK
| | - Jian Chen
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Mirae Park
- Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Joana Alcada
- Imperial College Healthcare NHS Trust, London, UK
| | - Laura Martin
- Imperial College Healthcare NHS Trust, London, UK
| | - Meg Coleman
- Imperial College Healthcare NHS Trust, London, UK
| | - Sarah Elkin
- Imperial College Healthcare NHS Trust, London, UK
| | - Clare Ross
- Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Aaron Bell
- Imperial College Healthcare NHS Trust, London, UK
| | - Alice White
- Imperial College Healthcare NHS Trust, London, UK
| | | | | | | | - Solange Bramer
- Imperial College School of Medicine, Imperial College, London, UK
| | | | | | | | | | | | - Susan Copley
- Radiology Department, Imperial College Healthcare NHS Trust, London, UK
| | | | - Chloe I Bloom
- National Heart and Lung Institute, Imperial College, London, UK
| | - Onn Min Kon
- Imperial College Healthcare NHS Trust, London, UK.,National Heart and Lung Institute, Imperial College, London, UK
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