Objective: To evaluate telephone advice given in an emergency department.
Design: Prospective, observational study.
Setting: A community-based emergency department in a semi-rural/outer metropolitan setting, between August and November 1995.
Participants: All people telephoning the emergency department for medical advice.
Methods: Details of all calls, callers and patients were recorded. Within 72 hours, a follow-up call was initiated seeking replies to a series of standardised questions.
Main outcome measures: Number, timing and duration of calls; appropriateness of the advice given; compliance with the advice; and callers' satisfaction with the service.
Results: Over the four-month period, 1682 calls were received, 58% between 4pm and midnight. There were 33 telephone calls per 100 emergency department attendances. The mean call duration was 3.9 minutes (range, 0.25-25 minutes); 49% of patients were less than 14 years old, and 72% of callers phoned because of spontaneous illness. The advice given was considered inappropriate in only 1.4% of calls. Follow-up calls were made to 1132 people (67%), revealing a non-compliance rate of only 6.9% and a high level of caller satisfaction, with 99% of callers affirming a need for such a service.
Conclusions: The provision of telephone advice by emergency department staff is rated highly by the community and compliance with the advice is strong. Paediatric problems, arising as a result of spontaneous illness, predominate and there is a large bias towards after-hours use of the service. Experienced staff provide better advice.