Pediatric televisits and telephone triage: impact on use of a hospital emergency department
Sarria-Guerrero JA, Luaces-Cubells C, Jiménez-Fàbrega FX, Villamor-Ordozgoiti A, Isla Pera P, Guix-Comellas EM
Affiliation of the authors
Departamento de Enfermería Fundamental y Medicoquirúrgica, Facultad de Medicina y Ciencias de la Salud, Escuela de Enfermería de la Universidad de Barcelona, Barcelona, Spain. Servicio de Urgencias Pediátricas, Hospital de Sant Joan de Déu, Barcelona, Spain. Sistema de Emergencias Médicas del Departamento de Salud de Cataluña (SEM), Barcelona, Spain. Hospital Clínico. Departamento de Enfermería Fundamental y Medicoquirúrgica. Facultad de Medicina y Ciencias de la Salud. Escuela de Enfermería de la Universidad de Barcelona, Barcelona, Spain. Departamento de Salud Pública, Facultad de Medicina y Ciencias de la Salud, Escuela de Enfermería de la Universidad de Barcelona, Barcelona, Spain
Sarria-Guerrero JA, Luaces-Cubells C, Jiménez-Fàbrega FX, Villamor-Ordozgoiti A, Isla Pera P, Guix-Comellas EM. Pediatric televisits and telephone triage: impact on use of a hospital emergency department. Emergencias. 2019;31:257-60
Summary
Objectives.
To analyze the characteristics of remote telephone consultations (televisits) and triage of pediatric emergencies attended by the 24-hour emergency service of Catalonia (CatSalut Respon), and to describe the impact of televisits on callers’ decisions about whether or not to come to the emergency department and their opinion of the call service.
Methods.
Observational cross-sectional study. During the call, cases were classified according the Spanish and Andorran triage system. Patients who were sent to the hospital underwent triage again, and the 2 assigned triage levels were compared. The families were later called to check data and ask their opinion of the service. Sociodemographic and clinical data related to the cases were recorded.
Results.
A total of 370 televisits were made. Most cases (300, 81%) were not emergencies. Seventy-five callers (20.3%) were advised to go to an emergency department. Fever (P = .002) and questions about medication (P < .001) were the problems significantly associated with nonurgent cases. Nearly 46% of the cases classified as serious during telephone triage were also considered serious when the child was brought to the emergency department. The rate of agreement between the 2 triage levels was moderate. Over half the parents stated they had intended to go to the hospital before calling the service; 46% changed their mind based on the call.
Conclusions.
Fever and questions about medication were significantly associated with televisits for nonurgent cases. Nearly half the parents changed their mind about going to the emergency department after a televisit.
