Changes in the patient call volume and call characteristics to an epileptologist during the COVID-19 pandemic

Purpose A performance-improvement service project consisting of a series of drug information interventions was developed for pharmacy staff to improve the quality and consistency of drug information provided by clinical pharmacists at a university medical center. The impact of interventions was primarily assessed by attendee satisfaction; a secondary measurement was the use of the Stanford Drug Information Center (the center). Methods Five interventions reviewing different electronic drug-information references were presented in September and October 2005. The 1hour presentations consisted of live demonstrations to pharmacy staff. A handout with step-by-step instructions on how to access and search each reference was created and distributed along with a follow-up evaluation. At the end of the interventions, all of the handouts were compiled into a permanent drug-information resource manual. In addition, data regarding inhouse pharmacist call volume to the center and the type of questions asked by inhouse pharmacists were collected for 6 months before and after the interventions. Results Evaluations of the interventions were positive and indicated that the learning objectives for each session had been met. The number of requests from inhouse pharmacists actually increased for the 6-month period after the interventions, as compared to the 6-month period prior to the interventions. Conclusion Feedback from pharmacy staff was positive, and the performance improvement goal was met through the intervention program, as well as the development of a permanent drug-information resource manual. However, further education of pharmacy staff did not translate into decreased requests (lower call volume) to the center.

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National trends and state-level variation in the duration of incoming quitline calls to 1-800-QUIT-NOW during 2012–2015

The Journal of Smoking Cessation ◽

10.1017/jsc.2020.9 ◽

2020 ◽

Vol 15 (2) ◽

pp. 59-66

Author(s):

Nathan Mann ◽

Ann Malarcher ◽

Lei Zhang ◽

Asma Shaikh ◽

Jesse Thompson ◽

...

Keyword(s):

Service Delivery ◽

Service Provider ◽

State Level ◽

Level Variation ◽

Call Duration ◽

Incoming Call ◽

Using Data ◽

National Trends ◽

Delivery Models ◽

Call Volume

AbstractIntroductionThe duration of incoming quitline calls may serve as a crude proxy for the potential amount of reactive counseling provided.AimsTo explore whether call duration may be useful for monitoring quitline capacity and service delivery.MethodsUsing data on the duration of incoming quitline calls to 1-800-QUIT-NOW from 2012 through 2015, we examined national trends and state-level variation in average call duration. We estimated a regression model of average call duration as a function of total incoming calls, nationally and by state, controlling for confounders.ResultsFrom 2012 through 2015, average call duration was 11.4 min, nationally, and was 10 min or longer in 33 states. Average call duration was significantly correlated with quitline service provider. Higher incoming call volume was significantly associated with lower average call duration in 32 states and higher average call duration in five states (P-value <0.05). The relationship between call volume and call duration was not correlated with quitline service provider.ConclusionsVariation in average call duration across states likely reflects different service delivery models. Average call duration was associated with call volume in many states. Significant changes in call duration may highlight potential quitline capacity issues that warrant further investigation.

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Temporal Trends and Future Predictions of Regional EMS System Utilization Using Statistical Modeling

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19005065 ◽

2019 ◽

Vol 35 (1) ◽

pp. 32-40 ◽

Cited By ~ 1

Author(s):

Michael J. Carr ◽

Robert Bauter ◽

Philip Shepherd ◽

Vincent Robbins ◽

A.J. McKechnie ◽

...

Keyword(s):

Life Support ◽

Temporal Trends ◽

Computer Assisted ◽

Service Access ◽

Best Fitting ◽

Per Capita ◽

Increasing Trends ◽

Future Utilization ◽

Model Approach ◽

Call Volume

AbstractIntroduction:Trends in utilization of Emergency Medical Services (EMS) systems can be used to extrapolate future use of an EMS system, which will be valuable for the budgeting and planning of finances and resources. The best model for incorporation of seasonal and regional fluctuations in utilization to predict future utilization is unknown.Problem:Authors aimed to trend patterns of utilization in a regional EMS system to identify the needs of a growing population and to allow for a better understanding of how the EMS system is used on a basis of call volume and frequency of EMS transportation. The authors then used a best-fitting prediction model approach to show how the studied EMS system will be used in future years.Methods:Systems data were retrospectively extracted by using the electronic medical records of the studied EMS system and its computer-assisted dispatch (CAD) database from 2010 through 2017. All EMS dispatches entering the system’s 9-1-1 public service access point were captured. Annual utilization data were available from 2010 through 2017, while quarterly data were available only from 2013 through 2017. The 9-1-1 utilization per capita, Advanced Life Support (ALS) utilization per capita, and ALS cancel rates were calculated and trended over the study period. The methods of prediction were assessed through a best-fitting model approach, which statistically suggested that Additive Winter’s approach (SAS) was the best fit to determine future utilization and ALS cancel rates.Results:Total 9-1-1 call volume per capita increased by 32.46% between 2010 and 2017, with an average quarterly increase of 0.78% between 2013 and 2017. Total ALS call volume per capita increased by 1.93% between 2010 and 2017. Percent ALS cancellations (cancelled en route to scene) increased by eight percent between 2010 and 2017, with an average quarterly increase of 0.42% (2013–2017). Predictions to end of 2019 using Additive Winter’s approach demonstrated increasing trends in 9-1-1 call volume per capita (R2 = 0.47), increasing trends of ALS utilization per capita (R2 = 0.71), and increasing percent ALS cancellation (R2 = 0.93). Each prediction showed increasing future trends with a 95% confidence interval.Conclusions:The authors demonstrate paramount per capita increases of 9-1-1 call volume in the studied ALS system. There are concomitant increases of ALS cancellations prior to arrival, which suggests a potential burden on this regional ALS response system.

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The Black Cloud Phenomenon in Hand Surgery

Hand ◽

10.1177/1558944718770206 ◽

2018 ◽

Vol 14 (6) ◽

pp. 819-822

Author(s):

Emily Zhao ◽

Nathan Tiedeken ◽

William Wang ◽

John Fowler

Keyword(s):

Trauma Center ◽

Hand Surgery ◽

Patient Transfers ◽

Level I ◽

Call Volume

Background: The term black cloud for a surgeon is generally used to describe someone who is unusually busy compared with his or her counterparts, and it is a superstition that tends to pervade the medical world. The purpose of this study is to investigate whether black clouds exist in hand surgery. Methods: We examined one academic year’s worth of hand surgery–specific call at a level I trauma center and tabulated the number of hand-related patient transfers and add-on cases per surgeon. Each surgeon was given a black cloud rating by the fellows who were in training that year. Correlations were made between the black cloud rating and the surgeons’ call volume. Results: There were 12 surgeons who shared 365 days of hand call, and 5 of them are hand surgery fellowship trained. Those 5 surgeons tended to be busier on their call days, with more cases added on overnight and the next day, and also had worse black cloud ratings than the 7 non–hand fellowship trained surgeons. Conclusions: In regard to hand surgery, while true emergencies occur and require emergent intervention, how busy hand surgeons may be during call may be influenced by a variety of factors not related to their patients’ problems but rather their daily schedules, their hospitals’ ability to facilitate add-on cases, and their rapport with their fellow surgeons to share case loads.

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P004: Effect of telephone triage (811) calls on a regional poison centre

CJEM ◽

10.1017/cem.2019.195 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S64

Author(s):

S. Alrobaian ◽

K. Hurley ◽

E. Fitzpatrick ◽

L. Mosher ◽

M. Young ◽

...

Keyword(s):

Care Facility ◽

Time Of Day ◽

Categorical Variables ◽

Future Research ◽

Telephone Triage ◽

Poison Centre ◽

Phone Calls ◽

The Impact ◽

Watson Statistic ◽

Call Volume

Introduction: Telephone Triage Services (TTS) manage phone calls from the public regarding general medical problems and provide telephone advice. This telephone based care can overlap with care provided by Poison Centres. Our objective was to examine the impact of a provincial 811 TTS on the IWK Regional Poison Centre (RPC). Methods: This is a retrospective descriptive study using interrupted time series methodology. We compared monthly IWK RPC call volume in the pre-811 era (January 2007-July 2009) and the post-811 era (September 2009-December 2017). We summarized the characteristics of callers who accessed the IWK RPC in terms of client age, sex, intentionality, time of day, call disposition and outcome. Caller characteristics were compared between the pre- and post-811 eras using chi-square test for categorical variables. We used segmented regression analysis to evaluate changes in slope of call volume in the pre- and post 811 eras. The Durbin-Watson statistic was performed to test for serial correlation and the Dickey-Fuller test to investigate seasonality. Results: The dataset included 82683 calls to the IWK RPC – 27028 pre-811 and 55655 post-811. Overall, 55% of calls were for female clients and the largest age group was children aged 0-5 years (37%). Most calls originated from home (47%), followed by a health care facility (23%). Most calls were managed at home (65%). Less than 3% of calls resulted in major effect or death. The Durbin Watson statistic was not statistically significant (p = 0.94). The Dickey-Fuller test indicated series stationarity (p = 0.001). There was no statistically significant change in call volume to the IWK RPC due to the introduction of 811 (p = 0.39). There was no significant variation by time of day, day of week or month, with most calls occurring in the evening. There were significantly more calls regarding intentional ingestions in the post-811 era (23% vs. 19% pre-811, p < .001). Outcomes in the pre and post 811 eras were as follows: minor/no effect/non-toxic/minimal 80% vs. 78%; moderate 7% vs. 10%; and, major/death 1.7% vs. 2.0%. Conclusion: The introduction of a TTS did not change call volumes at our RPC. The increase in the percentage of calls about intentional ingestions may reflect an increase in call acuity as the 811-TTS likely manages calls about minor/non-toxic ingestions without consulting with the RPC. Our future research will examine the nature of poison related calls to the 811-TTS.

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607 Reducing Burnout Related to Night Shift Calls to Physicians – a Process Improvement Project

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.233 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S146-S147

Author(s):

Kristy D Hemingway ◽

Victor Cabrera

Keyword(s):

Process Improvement ◽

Quality Care ◽

Night Shift ◽

Work Force ◽

Improvement Project ◽

New Nurses ◽

Time Period ◽

Nurses And Physicians ◽

Contact Response ◽

Call Volume

Abstract Introduction Call volume is directly linked to resident and physician burnout according to the literature. Nurse education and experience effect their ability to prioritize events that require a call to a physician, which can lead to increased calls for non-emergent issues. This is particularly challenging at night when resources are limited and physician workload is increased. Our burn team was experiencing high call volumes at night and the attending and resident physicians collaborated with nursing to initiate a process improvement that would address this issue so that burnout could be prevented from both nursing and physician teams. The overall goal was to reduce the call volume at night while still maintaining safe, quality care for our patients. Methods A call log was developed to track calls made to MD’s at night for a one-week period in September 2018 and then again in February 2019. The log included the time, the reason, the physician team, method of contact, response and the number of attempts to call. Based on the results of the September 2018 tracking log, 3 interventions were created and implemented before tracking again in February 2019. The 3 interventions implemented included: Results Reduction in calls was achieved. Calls to the burn team were reduced by 71% from period in September 2018 to the time period in February 2019. Concerns were reduced from 17 to 5 indicating improved knowledge on ability to prioritize routine versus urgent calls. Conclusions Collaboration amongst nursing and physicians to reduce calls at night can be achieved when a true understanding of the nature of the calls are identified. Having data logs of the calls allowed the team to break down urgent, emergent and important needs so that education could be provided to the nursing team, which then helped them analyze appropriate reasons to call physicians at night. Proactive calls or rounding also developed from this project have contributed to improved relationships between nurses and physicians as well as decreased calls. Applicability of Research to Practice The generational change in the work force requires considerable forethought in regards to education and orientation of new nurses working in the acute care setting. This process improvement project provides a template for others working in burn centers to implement methods to educate nurses and physicians on the importance of collaborating to define urgent, emergent and routine needs of our patients so that both benefit from being able to provide excellent patient care by minimizing unnecessary calls at night.

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Examining Telephone Calls in Ambulatory Oncology

Journal of Oncology Practice ◽

10.1200/jop.0922002 ◽

2009 ◽

Vol 5 (2) ◽

pp. 57-60 ◽

Cited By ~ 20

Author(s):

Marie Flannery ◽

Shannon M. Phillips ◽

Catherine A. Lyons

Keyword(s):

High Volume ◽

Telephone Call ◽

Practice Characteristics ◽

Ambulatory Oncology ◽

Specific Practice ◽

Telephone Calls ◽

Oncology Practice ◽

Outpatient Appointments ◽

The Impact ◽

Call Volume

Purpose: A large component of ambulatory oncology practice is management of telephone calls placed to and from the practice between outpatient appointments. However, scant information is available in the literature concerning oncology practice telephone calls. The specific aims of this study were to define telephone call volume and distribution in an active ambulatory oncology practice, describe the callers and reasons for the telephone calls, and examine any differences in call volume by practice characteristics. Methods: A descriptive retrospective design was used to analyze medical oncology and hematology telephone calls in a 4-month period. Two investigator-developed tools were validated and used to collect data on telephone call content and patient demographics. Results: The sample included 5,283 telephone calls to or from 1,486 different individuals. Individuals making and/or receiving more than one telephone call in the study period represented 56% of the telephone calls. For every 10 scheduled clinic appointments, seven telephone calls were received or made. The volume of telephone calls was significantly higher on Mondays and in the mornings. The reasons for high-volume telephone calls by diagnosis and frequency were identified, with 30% of telephone calls involving multiple reasons. Conclusion: The data demonstrate the impact of telephone calls on ambulatory oncology practice and highlight the complex and highly variable actions required to manage the telephone calls. The findings confirm and document specific practice patterns and identify subgroups that target repeat telephone calls as an area for improvement.

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