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01-07-2009 | Onderzoek
De kwaliteit van telefonische triage op huisartsenposten
Auteurs: Hay Derkx, Bas Maiburg, Ron Winkens, Arno Muijtjens, Harrie van Rooij, André Knottnerus
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Samenvatting
Derkx HP, Rethans JJ, Maiburg BH, Winkens RAG, Muijtjens AM, Van Rooij HG, Knottnerus JA. De kwaliteit van telefonische triage op huisartsenposten. Huisarts Wet 2009;52(7):326-31.
Doel Om de kwaliteit en veiligheid van telefonische triage op een huisartsenpost te bepalen moeten we de kwaliteit van de verschillende fasen van dit zorgproces onderzoeken. Dit betekent dat we niet alleen moeten beoordelen of de triagist het juiste urgentieniveau heeft bepaald, maar ook dat we de kwaliteit van de medisch inhoudelijke vragen en de inhoud van een zelfzorg- en vangnetadvies moeten onderzoeken.
Methode Voor de uitvoering van dit onderzoek belden twaalf telefonische simulatiepatiënten (TSP’s) in de periode april 2006 tot juli 2007 naar zeventien verschillende huisartsenposten voor zeven medische problemen. De TSP’s belden iedere huisartsenpost voor iedere casus driemaal.
Resultaten De triagisten stelden gemiddeld 21% van de verplichte vragen die in de standaarden waren vermeld. Gemiddeld 54% van alle gestelde vragen behoorde tot de categorie verplichte vragen. Niet altijd schatten de triagisten het belang van een antwoord op een vraag op de juiste wijze in. Triagisten bepaalden voor 58% van alle gesprekken de gewenste urgentie. Voor 41% was het urgentieniveau te laag en voor 1% te hoog ingeschat. De kwaliteit van de zelfzorg- en vangnetadviezen varieerde sterk per casus en was op alle huisartsenposten beperkt.
Conclusie De triagisten formuleerden meestal een zorgadvies na het stellen van een zeer beperkt aantal verplichte vragen, waardoor ze een mogelijk gezondheidsrisico voor de patiënt niet tot het minimum beperkten. Als we de kwaliteit tijdens opeenvolgende fasen van het zorgproces van telefonische triage-onderzoeken, kunnen we vaststellen in hoeverre triagisten de juiste urgentie bepalen op basis van voldoende en juist geïnterpreteerde informatie of dat het toeval daarbij een grote rol heeft gespeeld. Om de veiligheid van telefonische triage te bevorderen moeten triagisten niet alleen de juiste vragen stellen en de antwoorden correct inschatten, maar ook een volledig zelfzorg- en vangnetadvies geven.
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Literatuur
1.
go back to reference Crouch R. An investigation into effects of a computer based decision support program on accident and emergency nurses’ assessment strategies in telephone consultation [dissertation]. Brighton, UK: University of Surrey, 2000.
Crouch R. An investigation into effects of a computer based decision support program on accident and emergency nurses’ assessment strategies in telephone consultation [dissertation]. Brighton, UK: University of Surrey, 2000.
2.
go back to reference Christensen MB, Olesen F. Out of hours service in Denmark: Evaluation five years after reform. BMJ 1998;316:1502-5.
Christensen MB, Olesen F. Out of hours service in Denmark: Evaluation five years after reform. BMJ 1998;316:1502-5.
3.
go back to reference Yanovski SZ, Yanovski JA, Malley JD, Brown RL, Balaban DJ. Telephone triage by primary care physicians. Pediatrics 1992;89:701-6.
Yanovski SZ, Yanovski JA, Malley JD, Brown RL, Balaban DJ. Telephone triage by primary care physicians. Pediatrics 1992;89:701-6.
4.
go back to reference Giesen P. Quality of out-of-hours primary care in the Netherlands [proefschrift]. Nijmegen: University of Nijmegen, 2007.
Giesen P. Quality of out-of-hours primary care in the Netherlands [proefschrift]. Nijmegen: University of Nijmegen, 2007.
5.
go back to reference Foster J, Jessopp L, Dale J. Concerns and confidence of general practitioners in providing telephone consultations. Br J Gen Pract 1999;49:111-3.
Foster J, Jessopp L, Dale J. Concerns and confidence of general practitioners in providing telephone consultations. Br J Gen Pract 1999;49:111-3.
6.
go back to reference Car J, Freeman G, Partridge M, Sheikh A. Improving quality and safety of telephone based delivery of care: Teaching telephone consultation skills. Qual Saf Health Care 2004;13:2-3.
Car J, Freeman G, Partridge M, Sheikh A. Improving quality and safety of telephone based delivery of care: Teaching telephone consultation skills. Qual Saf Health Care 2004;13:2-3.
7.
go back to reference Post J. Grootschalige huisartsenzorg buiten kantooruren [proefschrift]. Groningen: Universiteit van Groningen, 2004.
Post J. Grootschalige huisartsenzorg buiten kantooruren [proefschrift]. Groningen: Universiteit van Groningen, 2004.
8.
go back to reference Fatovich DM, Jacobs IG, McCance JP, Sidney KL, White RJ. Emergency department telephone advice. Med J Aust 1998;169:143-6.
Fatovich DM, Jacobs IG, McCance JP, Sidney KL, White RJ. Emergency department telephone advice. Med J Aust 1998;169:143-6.
9.
go back to reference Belman S, Chandramouli V, Schmitt BD, Poole SR, Hegarty T, Kempe A. An assessment of pediatric after-hours telephone care: A 1-year experience. Arch Pediatr Adolesc Med 2005;159:145-9.
Belman S, Chandramouli V, Schmitt BD, Poole SR, Hegarty T, Kempe A. An assessment of pediatric after-hours telephone care: A 1-year experience. Arch Pediatr Adolesc Med 2005;159:145-9.
10.
go back to reference Light PA, Hupcey JE, Clark MB. Nursing telephone triage and its influence on parents’ choice of care for febrile children. J Pediatr Nurs 2005;20:424-9.
Light PA, Hupcey JE, Clark MB. Nursing telephone triage and its influence on parents’ choice of care for febrile children. J Pediatr Nurs 2005;20:424-9.
11.
go back to reference Crouch R, Patel A, Williams S, Dale J. An analysis of telephone calls to an inner-city accident and emergency department. J R Soc Med 1996;89:324-8.
Crouch R, Patel A, Williams S, Dale J. An analysis of telephone calls to an inner-city accident and emergency department. J R Soc Med 1996;89:324-8.
12.
go back to reference Wahlberg AC, Wredling R. Telephone nursing: Calls and caller satisfaction. Int J Nurs Pract 1999;5:164-70.
Wahlberg AC, Wredling R. Telephone nursing: Calls and caller satisfaction. Int J Nurs Pract 1999;5:164-70.
13.
go back to reference Salisbury C, Trivella M, Bruster S. Demand for and supply of out of hours care from general practitioners in England and Scotland: Observational study based on routinely collected data. BMJ 2000;320:618-21.
Salisbury C, Trivella M, Bruster S. Demand for and supply of out of hours care from general practitioners in England and Scotland: Observational study based on routinely collected data. BMJ 2000;320:618-21.
14.
go back to reference Chowdhury S. The power of six sigma. London: Prentice Hall, 2001.
Chowdhury S. The power of six sigma. London: Prentice Hall, 2001.
15.
go back to reference Silvermann J, Kurtz S, Draper J. Skills for communicating with patients. Oxford: Radcliffe Medical Press, 2000.
Silvermann J, Kurtz S, Draper J. Skills for communicating with patients. Oxford: Radcliffe Medical Press, 2000.
16.
go back to reference Dale J, Williams S, Crouch R, Patel A. A study of out-of-hours telephone advice from an A&E department. Br J Nurs 1997;6:171-4.
Dale J, Williams S, Crouch R, Patel A. A study of out-of-hours telephone advice from an A&E department. Br J Nurs 1997;6:171-4.
17.
go back to reference NHG Telefoonwijzer. Utrecht, Nederlands Huisartsen Genootschap, 2000.
NHG Telefoonwijzer. Utrecht, Nederlands Huisartsen Genootschap, 2000.
18.
go back to reference Edwards B. Seeing is believing – picturebuilding: A key component of telephone triage. J Clin Nurs 1998;7:51-7.
Edwards B. Seeing is believing – picturebuilding: A key component of telephone triage. J Clin Nurs 1998;7:51-7.
19.
go back to reference Derkx HP, Rethans J-JE, Knottnerus JA, Ram P. Assessing communication skills of clinical call handlers working at an out of hours centre: The development of the RICE rating scale. Br J Gen Pract 2007;57:383-7.
Derkx HP, Rethans J-JE, Knottnerus JA, Ram P. Assessing communication skills of clinical call handlers working at an out of hours centre: The development of the RICE rating scale. Br J Gen Pract 2007;57:383-7.
20.
go back to reference Neighbour R. The inner consultation: How to develop an effective and intuitive consulting style. Lancaster, UK: M T Press, 1987.
Neighbour R. The inner consultation: How to develop an effective and intuitive consulting style. Lancaster, UK: M T Press, 1987.
21.
go back to reference Higgs RH, Armstrong E, Blache G, Jessopp L, Peters M. Telephone consultations [electronic response to Car J, Sheikh A. Telephone consultations]. BMJ 2003. www.bmj.com/cgi/eletters/326/7396/966#32282.
Higgs RH, Armstrong E, Blache G, Jessopp L, Peters M. Telephone consultations [electronic response to Car J, Sheikh A. Telephone consultations]. BMJ 2003. www.bmj.com/cgi/eletters/326/7396/966#32282.
22.
go back to reference Rethans J-J, Gorter S, Bokken L, Morrison L. Unannounced standardized patients in real practice: A systematic literature review. Med Educ 2007;41:537-49.
Rethans J-J, Gorter S, Bokken L, Morrison L. Unannounced standardized patients in real practice: A systematic literature review. Med Educ 2007;41:537-49.
23.
go back to reference Van der Vleuten C, Swanson D. Assessment of clinical skills with standardized patients: State of the art. Teach Learn Med 1990;2:58-76.
Van der Vleuten C, Swanson D. Assessment of clinical skills with standardized patients: State of the art. Teach Learn Med 1990;2:58-76.
24.
go back to reference Rethans JJ, Norcini JJ, Baron-Maldonado M, Blackmore D, Jolly BC, LaDuca T, et al. The relationship between competence and performance: Implications for assessing practice performance. Med Educ 2002;36:901-9.
Rethans JJ, Norcini JJ, Baron-Maldonado M, Blackmore D, Jolly BC, LaDuca T, et al. The relationship between competence and performance: Implications for assessing practice performance. Med Educ 2002;36:901-9.
25.
go back to reference Moriarty H, McLeod D, Dowell A. Mystery shopping in health service evaluation. Br J Gen Pract 2003;53:942-6.
Moriarty H, McLeod D, Dowell A. Mystery shopping in health service evaluation. Br J Gen Pract 2003;53:942-6.
26.
go back to reference Bron: Vereniging Huisartsenposten Nederland.
Bron: Vereniging Huisartsenposten Nederland.
27.
go back to reference Brennan RL. Generalizability theory. New York: Springer-Verlag, 20.
Brennan RL. Generalizability theory. New York: Springer-Verlag, 20.
28.
go back to reference Leprohon J, Patel VL. Decision-making strategies for telephone triage in emergency medical services. Med Decis Making 1995;15:240-53.
Leprohon J, Patel VL. Decision-making strategies for telephone triage in emergency medical services. Med Decis Making 1995;15:240-53.
29.
go back to reference O’Brien RP, Miller TL. Urgent care center pediatric telephone advice. Am J Emerg Med 1990;8:496-7.
O’Brien RP, Miller TL. Urgent care center pediatric telephone advice. Am J Emerg Med 1990;8:496-7.
30.
go back to reference Lattimer V, George S, Thompson F, Thomas E, Mullee M, Turnbull J, et al. Safety and effectiveness of nurse telephone consultation in out of hours primary care: Randomised controlled trial. BMJ 1998;317:1054-9.
Lattimer V, George S, Thompson F, Thomas E, Mullee M, Turnbull J, et al. Safety and effectiveness of nurse telephone consultation in out of hours primary care: Randomised controlled trial. BMJ 1998;317:1054-9.
31.
go back to reference Parkin JD, Smith IL, O’Neill AI, Ibrahim KM, Butcher LA. Mild bleeding disorders: A clinical and laboratory study. Med J Aust 1992;156:614-7.
Parkin JD, Smith IL, O’Neill AI, Ibrahim KM, Butcher LA. Mild bleeding disorders: A clinical and laboratory study. Med J Aust 1992;156:614-7.
32.
go back to reference Viehweg TL, Roberson JB, Hudson JW. Epistaxis: Diagnosis and treatment. J Oral Maxillofac Surg 2006;64:511-8.
Viehweg TL, Roberson JB, Hudson JW. Epistaxis: Diagnosis and treatment. J Oral Maxillofac Surg 2006;64:511-8.
33.
go back to reference Aitken M. Telephone advice about an infant given by after-hours clinics and emergency departments. N Z Med J 1995;108:315-7.
Aitken M. Telephone advice about an infant given by after-hours clinics and emergency departments. N Z Med J 1995;108:315-7.
34.
go back to reference Carbajal R, Barthez P, Blanc P, Paupe A, Lenclen R, Olivier-Martin M, et al. Telephonic advice by an emergency department given in a simulated pediatric case. Arch Pediatr 1996;3:964-8.
Carbajal R, Barthez P, Blanc P, Paupe A, Lenclen R, Olivier-Martin M, et al. Telephonic advice by an emergency department given in a simulated pediatric case. Arch Pediatr 1996;3:964-8.
35.
go back to reference Tijssen R. De ‘NHG-Telefoonwijzer’: een goede leidraad voor triage? Nijmegen: Faculteit Geneeskunde, 2004. [UMC 045125.]
Tijssen R. De ‘NHG-Telefoonwijzer’: een goede leidraad voor triage? Nijmegen: Faculteit Geneeskunde, 2004. [UMC 045125.]
36.
go back to reference Belman S, Murphy J, Steiner JF, Kempe A. Consistency of triage decisions by call center nurses. Ambul Pediatr 2002;2:396-400.
Belman S, Murphy J, Steiner JF, Kempe A. Consistency of triage decisions by call center nurses. Ambul Pediatr 2002;2:396-400.
37.
go back to reference Fatovich DM, Jacobs IG, McCance JP, Sidney KL, White RJ. Emergency department telephone advice. Med J Aust 1998;169:143-6.
Fatovich DM, Jacobs IG, McCance JP, Sidney KL, White RJ. Emergency department telephone advice. Med J Aust 1998;169:143-6.
38.
go back to reference Dale J, Williams S, Foster T, Higgins J, Snooks H, Crouch R, et al. Safety of telephone consultation for ‘non-serious’ emergency ambulance service patients. Qual Saf Health Care 2004;13:363-73.
Dale J, Williams S, Foster T, Higgins J, Snooks H, Crouch R, et al. Safety of telephone consultation for ‘non-serious’ emergency ambulance service patients. Qual Saf Health Care 2004;13:363-73.
39.
go back to reference Grol R. Beliefs and evidence in changing clinical practice. BMJ 1997;315:418-21.
Grol R. Beliefs and evidence in changing clinical practice. BMJ 1997;315:418-21.
40.
go back to reference Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: A systematic review of trials to identify features critical to success. BMJ 2005;330:740-1.
Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: A systematic review of trials to identify features critical to success. BMJ 2005;330:740-1.
Metagegevens
- Titel
- De kwaliteit van telefonische triage op huisartsenposten
- Auteurs
-
Hay Derkx
Bas Maiburg
Ron Winkens
Arno Muijtjens
Harrie van Rooij
André Knottnerus
- Publicatiedatum
- 01-07-2009
- Uitgeverij
- Bohn Stafleu van Loghum
- DOI
- https://doi.org/10.1007/BF03085669