Telephone advice nursing services in a US health maintenance organization.
We studied telephone advice nursing (TAN) in the US. We recorded 4269 TAN calls in four regions served by Kaiser Permanente, a health maintenance organization. A call description form was used to record information regarding both calls and callers. The mean call length was 5.9 min (SD 3.6, range 0.3-35.8); 300 calls lasted less than 2 min. The mean call length differed significantly across regions, from 4.4 min in Hawaii to 8.7 min in Southern California. Calls to call centres lasted an average of 6.5 min (SD 3.8), compared with 4.2 min (SD 2.9) for those to medical offices. These differences were significant. Although 42% of calls required some further medical management, only 18% (n = 754) resulted in an urgent disposition, and only 16% (n = 121; 3% of all calls) of the urgent dispositions involved referral to emergency services. The likelihood of urgent disposition varied significantly by region. Callers generally used the TAN services for the right reasons, that is, with questions or concerns that could be reasonably handled by telephone advice nurses.
School of Nursing, Oregon Health and Science University, Portland, Oregon 97239-3702, USA. shapiro@ohsu.edu
Susan E
SE
Shapiro
Shigeko
S
Izumi
Christine A
CA
Tanner
Susan R
SR
Moscato
Barbara G
BG
Valanis
Marion R
MR
David
Christina M
CM
Gullion
D000328:Adult; D004630:Emergencies; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D009739:Nursing Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D012017:Referral and Consultation; D019114:Remote Consultation / Q000706:statistics & numerical data*; D013689:Telephone / Q000706:statistics & numerical data*; D013996:Time and Motion Studies; D014481:United States