PTH-34 Diagnostic outcomes after cancelled gastroscopy: telephone triage of 600 patients during the COVID-19 pandemic

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

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Reliability and validity of an original nurse telephone triage tool for out-of-hours primary care calls: the SALOMON algorithm

Acta Clinica Belgica ◽

10.1080/17843286.2021.1936353 ◽

2021 ◽

pp. 1-7

Author(s):

Edmond Brasseur ◽

Allison Gilbert ◽

Anne-Françoise Donneau ◽

Justine Monseur ◽

Alexandre Ghuysen ◽

...

Keyword(s):

Primary Care ◽

Reliability And Validity ◽

Telephone Triage ◽

Out Of Hours

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P63 Improving cervical smear uptake through an Automated Voice Messages Reminder

BJS Open ◽

10.1093/bjsopen/zrab032.062 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

Francesca Bladt ◽

Felyx Wong ◽

Francesca Bladt

Keyword(s):

Cervical Cancer ◽

Low Cost ◽

Cervical Screening ◽

Telephone Triage ◽

Cervical Smear ◽

Screening Programs ◽

Smear Test ◽

Voice Message ◽

The Uk ◽

Busy Schedule

Abstract National cervical screening programs have played a pivotal role in the prevention of cervical cancer. However, practices across the UK have reached an all-time low in cervical screening uptake. This study aimed to assess the efficacy of implementing an automated voice message reminder within the local general practice (GP) telephone triage system and explore the reasons which deter eligible patients away from cervical screening. A 20-second voice-message reminder in the telephone queue was played, addressing key risk factors along with a message from a child who lost his mother to cervical cancer. From the anonymised GP database, weekly new smear test bookings were monitored from 4 weeks prior until 2 weeks after the intervention was implemented. To qualitatively assess factors which deter patients away from screening, female patients were randomly sampled to fill in an anonymous questionnaire. The use of a low-cost 20 second voice message in the telephone queue across UK GP practices could be an effective method to increase cervical smear test coverage towards the national target of 80%. 35 questionnaire responses were received, main themes reported for not attending screening include embarrassment(37%), busy schedule(32%) and cultural differences(24%). In the week following the intervention, cervical smear tests increased more than 2-fold, from an average of 12 to 26 smears per week. This could be partly due to the convenient timing of voice recording, reminding them to book both appointments simultaneously and the child’s emotive message.

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Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-042351 ◽

2020 ◽

Vol 10 (11) ◽

pp. e042351

Author(s):

Kathryn Eastwood ◽

Dhanya Nambiar ◽

Rosamond Dwyer ◽

Judy A Lowthian ◽

Peter Cameron ◽

...

Keyword(s):

Cohort Study ◽

Older Adult ◽

Retrospective Cohort Study ◽

Older Patients ◽

Retrospective Cohort ◽

Vital Signs ◽

Telephone Triage ◽

Ambulance Dispatch ◽

Emergency Ambulance ◽

Primary Triage

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

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Fast Focus Ultrasound Liver Technique for the Assessment of Cystic Echinococcosis in Sheep

Animals ◽

10.3390/ani11020452 ◽

2021 ◽

Vol 11 (2) ◽

pp. 452 ◽

Cited By ~ 1

Author(s):

Giuliano Borriello ◽

Jacopo Guccione ◽

Antonio Di Loria ◽

Antonio Bosco ◽

Paola Pepe ◽

...

Keyword(s):

Body Weight ◽

Focused Ultrasound ◽

Ultrasound Examination ◽

Focus Ultrasound ◽

The Body ◽

Weight Group ◽

Ultrasound Technique ◽

Female Sheep ◽

Weight Groups ◽

Diagnostic Outcomes

A complete ultrasound examination (cUS) of the liver was performed on 172 female sheep and compared to the performance of a fast-focused ultrasound technique to diagnose echinococcal cysts. The scanned area was divided in: HYP (right hypocondrium), zone (Z)1 from HYP to the 11th intercostal space (IS), Z2 (10th–8th IS) and Z3 (7th–5th IS). Contiguous scans were also examined (HYP + Z1, Z1 + Z2, Z2 + Z3). Furthermore, during the procedures, the sheep were divided into three groups according to the body weight: Group (G) 1 (lighter), G2 (medium), and G3 (heavier). Finally, diagnostic outcomes were compared with necropsy findings. cUS obtained the highest values of sensitivity (Se) (91%), Specificity (Sp) (80%), and positive-zones (124/138, 90%), as compared to the other scans. cUS was also characterized by high values of Se and Sp and was able to identify a great number of positive-zones, when sheep were divided by body-weight groups. Similar performances were obtained in G1 by HYP (Se: 91%–Sp: 82%; 18/20, 90% of positive-zones) and HYP + Z1 scans (Se: 91%–Sp: 82; 90% of positive-zones, 18/20). Thus, in lighter breeds, the examination of HYP and HYP + Z1 scan windows could be considered reliable techniques for identifying the infected animals, while in heavier sheep the cUS still represents the best option.

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At Risk for Schizophrenic or Affective Psychoses? A Meta-Analysis of DSM/ICD Diagnostic Outcomes in Individuals at High Clinical Risk

Schizophrenia Bulletin ◽

10.1093/schbul/sbs060 ◽

2012 ◽

Vol 39 (4) ◽

pp. 923-932 ◽

Cited By ~ 111

Author(s):

Paolo Fusar-Poli ◽

Andreas Bechdolf ◽

Matthew John Taylor ◽

Ilaria Bonoldi ◽

William T. Carpenter ◽

...

Keyword(s):

At Risk ◽

Meta Analysis ◽

Affective Psychoses ◽

Clinical Risk ◽

High Clinical Risk ◽

Diagnostic Outcomes

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Performance of a new guideline for telephone triage in out-of-hours services in Belgium: A pilot study using simulated patients

Health Services Management Research ◽

10.1177/0951484820921809 ◽

2020 ◽

Vol 33 (4) ◽

pp. 166-171

Author(s):

Stefan Morreel ◽

Hilde Philips ◽

Annelies Colliers ◽

Veronique Verhoeven

Keyword(s):

General Practitioner ◽

Primary Objective ◽

Phone Call ◽

Simulated Patients ◽

Telephone Triage ◽

Out Of Hours ◽

Important Variation ◽

Phone Calls ◽

The Right ◽

Urgency Level

Background Patients in Belgium needing out-of-hours care have two options: the emergency department or the general practitioner on call often organised in a general practitioner cooperative. Currently, there is no triage system in Belgium so patients do not know where to go. Methods Our primary objective was to examine the ability of a newly developed telephone guideline, called 1733, to adequately estimate the urgency of health problems presented by simulated patients. Ten clinical vignettes were presented to 12 operators in a simulated phone call. The operators had to assign a protocol, urgency level and resource to dispatch (ambulance, general practitioner house visit, etc.) to each case. Results A total of 120 phone calls were analysed. The operators chose the right protocol in 69% and the correct urgency level in 35% of the cases. The proportion of under- and over-triage was 26% and 39%, respectively. There was important variation in between the operators. The sensitivity for detecting highly urgent cases was 0.42, the specificity 0.92. Conclusion Using the new Belgian 1733 guideline for telephone triage, operators mostly chose the appropriate protocol but only chose the correct urgency in one out of three cases. In this phase of development, the studied telephone guideline is not ready for implementation.

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