title: Avoidable after-hours calls to physicians in family medicine.
abstract: OBJECTIVE
  To assess avoidability in after-hours telephone calls. Identification of predictors of avoidable calls is necessary so that system changes can be implemented in the interest of efficiency in patient care.
  
  
  BACKGROUND
  A new after-hours family physician call service was established in a large group practice to replace some of the resident call shifts and meet patient expectations.
  
  
  METHODS
  Call logs completed by physicians who were on call.
  
  
  METHODS
  A total of 131 completed after-hours calls. AVOIDABLE CALL: An after-hours call to a physician that could have been effectively handled by another person, by a communication mechanism, or at another time. ASSESSMENT RESULT: Call defined as avoidable or not avoidable as assessed by the physician on call.
  
  
  RESULTS
  Less than half (41.9%) of calls were avoidable. Run charts failed tests for shifts and runs. Patient age, time of day, and day of the week were not related to being avoidable, but avoidability varied by physician (P = .003).
  
  
  CONCLUSIONS
  The after-hours call service experienced high rates of avoidable calls. Avoidability was associated with the physician on call. Reducing avoidable after-hours calls to physicians will require building clinical consensus on which types of calls should be considered avoidable and how avoidable calls should be redirected.
authors.affiliation: Department of Family Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. rohrer.james@mayo.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.forename: Robert D
authors.initials: RD
authors.lastname: Sheeler
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Furst
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Bartel
mesh_terms: D039602:After-Hours Care / Q000706:statistics & numerical data*; D017677:Age Distribution; D004282:Documentation; D017598:Efficiency, Organizational; D005194:Family Practice; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D010865:Pilot Projects