Telephone triage in out of hours call centres

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1167 (Published 12 September 2008) Cite this as: BMJ 2008;337:a1167
  1. Josip Car, director of eHealth unit1,
  2. Elizabeth Koshy, clinical research fellow1,
  3. Derek Bell, professor of acute medicine2,
  4. Aziz Sheikh, professor of primary care research and development3
  1. 1Department of Primary Care and Social Medicine, Imperial College Faculty of Medicine, London W6 8RP
  2. 2Division of Medicine, Imperial College Faculty of Medicine, London SW7 2EH
  3. 3Division of Community Health Sciences, University of Edinburgh, Edinburgh EH8 9DX
  1. josip.car{at}imperial.ac.uk

    Concerns about quality and safety highlight the need for further evaluation

    Telephone triage, both for in hours and out of hours consultations, has increased dramatically in recent years, and in many respects this is welcome. Telephone consulting can improve access to care for many patients,1 and out of hours care provided by call centres in particular can improve the efficiency of healthcare provision.2 Several unanswered questions remain, however, with respect to the quality and safety of such clinical encounters because of the relative paucity of evidence on this mode of consulting.3

    The linked study by Derkx and colleagues (doi: 10.1136/bmj.a1264) highlights the potential shortcomings of telephone based consultations in the context of out of hours triage of patients in the Netherlands.4 Strengths of the study include a carefully considered sampling strategy of call centres and the use of standardised clinical encounters using simulated patients.

    Out of hours consultations are …

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