SATISFACTION WITH TELEPHONE ADVICE FROM AN ACCIDENT AND EMERGENCY DEPARTMENT - IDENTIFYING AREAS FOR SERVICE IMPROVEMENT

Objectives-Members of the public often telephone general practice, acc ident and emergency departments, and other health services for advice. However, satisfaction related to telephone consultation has received relatively Little attention. This study aimed to describe the views of callers to an accident and emergency department who expressed any ele ment of dissatisfaction about their telephone consultation. This was p art of a larger study intended to help identify areas for service impr ovement. Methods-A telephone consultation record form was used to docu ment details of advice calls made to the accident and emergency depart ment over a three month period. Callers who provided a telephone numbe r were followed up within 72 hours. The interviews were tape recorded, transcribed, and explored using content analysis for emerging themes related to dissatisfaction. Results-203 callers were contacted within 72 hours of their call, of which 197 (97%) agreed to participate. 11 ( 5.6%) expressed global dissatisfaction, and a further 34 (17%) callers expressed at least one element of dissatisfaction at some point durin g the interview. Sources of dissatisfaction fell into four broad categ ories, each of which included more specific aspects of dissatisfaction : 36 (80%) callers were dissatisfied with advice issues, 31 (69%) with process aspects, such as the interpersonal skills of the staff member who took the call, 23 (51%) due to lack of acknowledgement of physica l or emotional needs, and 11 (24%) due to access problems. Conclusion- This study supports the findings of other work and identifies three is sues for particular consideration in improving the practice of telepho ne consultation: (a) training of health professionals at both undergra duate and specialist levels should cover telephone communication skill s, (b) specific attention needs to be given to ensuring that the infor mation and advice given over the phone is reliable and consistent, and (c) organisational change is required, including the introduction of departmental policies for telephone advice which should become the sub ject of regular audit.