Improving quality and safety of telephone based delivery of care: teaching telephone consultation skills

Abstract

High quality telephone based health care delivered by appropriately trained staff should be available to all The opportunity to consult by telephone is now an integral part of any modern patient centred healthcare system.1 The public values the option of consulting by telephone, citing advantages of quicker access to care, greater convenience, and more choice in the way health care is received.2 In the United States up to a quarter of all primary care consultations are now conducted over the telephone, but there are also risks associated with this form of communication.3 Key approaches and skills that clinicians need to acquire to minimise these risks include use of detailed protocols for the organisation of a telephone service, structured evaluation of the urgency of calls, and issues to do with confidentiality. None of these has so far been incorporated into doctors’ formal training, and this needs to change. Telephone contacts are increasingly used as an extension of, or substitute for, traditional face to face contacts with a range of primary and secondary healthcare professionals. Telephone services now include delivery of routine and emergency care, facilitating health promotional interventions, obtaining results of laboratory investigations, and repeat prescriptions.2 Many doctors are, however, still …

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