Prospective study of telephone consultation and communication in pediatricinfectious diseases

Background. Subspecialists are often called on to provide informal or "curb side" telephone consultation. There is limited documentation of the time sp ent on, content, nature and source of such consultations by pediatric infec tious disease (PID) specialists. Nursing staff frequently assist physicians by triaging telephone calls. No previous studies have examined this aspect of their role in subspecialty practice. Methods. We prospectively recorded all telephone calls to a newly establish ed PID program for I year. Results were entered into a database and analyze d using the ABSTAT software. Results. A total of 621 calls were received by the PID specialist and 1260 by the PID nurse from March 1, 1999, through February 29, 2000. The mean nu mber of calls per month was 51.8 +/- 24.8 for the physician and 105 +/- 43. 3 for the nurse. The mean time spent per call was 9.6 +/- 5.9 min for the p hysician and 3.3 +/- 1.4 min for the nurse. A total of 103.5 h were spent d irectly on telephonic consultation/communication by the physician and 68.7 h by the nurse, respectively. Of the calls to the physician 78.6% came from other physicians, 51.5% being pediatricians in practice and 57% involving case management. Calls to the nurse were primarily from the laboratory (26. 3%), with 93% regarding patients seen on the inpatient or outpatient servic e. Conclusions. Telephone consultation/communication is an integral and import ant part of a PID practice.