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The quality, safety and governance of telephone triage and advice services - an overview of evidence from systematic reviews.
Lake, Rebecca; Georgiou, Andrew; Li, Julie; Li, Ling; Byrne, Mary; Robinson, Maureen; Westbrook, Johanna I.
Afiliação
  • Lake R; Australian Digital Health Agency, Level 25, 56 Pitt Street, Sydney, NSW, 2000, Australia.
  • Georgiou A; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia. andrew.georgiou@mq.edu.au.
  • Li J; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
  • Li L; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
  • Byrne M; Healthdirect Australia, Level 19, 133 Castlereagh Street, Sydney, NSW, 2000, Australia.
  • Robinson M; Healthdirect Australia, Level 19, 133 Castlereagh Street, Sydney, NSW, 2000, Australia.
  • Westbrook JI; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
BMC Health Serv Res ; 17(1): 614, 2017 Aug 30.
Article em En | MEDLINE | ID: mdl-28854916
BACKGROUND: Telephone triage and advice services (TTAS) are increasingly being implemented around the world. These services allow people to speak to a nurse or general practitioner over the telephone and receive assessment and healthcare advice. There is an existing body of research on the topic of TTAS, however the diffuseness of the evidence base makes it difficult to identify key lessons that are consistent across the literature. Systematic reviews represent the highest level of evidence synthesis. We aimed to undertake an overview of such reviews to determine the scope, consistency and generalisability of findings in relation to the governance, safety and quality of TTAS. METHODS: We searched PubMed, MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library for English language systematic reviews focused on key governance, quality and safety findings related to telephone based triage and advice services, published since 1990. The search was undertaken by three researchers who reached consensus on all included systematic reviews. An appraisal of the methodological quality of the systematic reviews was independently undertaken by two researchers using A Measurement Tool to Assess Systematic Reviews. RESULTS: Ten systematic reviews from a potential 291 results were selected for inclusion. TTAS was examined either alone, or as part of a primary care service model or intervention designed to improve primary care. Evidence of TTAS performance was reported across nine key indicators - access, appropriateness, compliance, patient satisfaction, cost, safety, health service utilisation, physician workload and clinical outcomes. Patient satisfaction with TTAS was generally high and there is some consistency of evidence of the ability of TTAS to reduce clinical workload. Measures of the safety of TTAS tended to show that there is no major difference between TTAS and traditional care. CONCLUSIONS: Taken as a whole, current evidence does not provide definitive answers to questions about the quality of care provided, access and equity of the service, its costs and outcomes. The available evidence also suggests that there are many interactional factors (e.g., relationship with other health service providers) which can impact on measures of performance, and also affect the external validity of the research findings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade da Assistência à Saúde / Linhas Diretas / Triagem / Telemedicina / Acessibilidade aos Serviços de Saúde / Pesquisa sobre Serviços de Saúde Tipo de estudo: Evaluation_studies / Overview / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Health Serv Res Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade da Assistência à Saúde / Linhas Diretas / Triagem / Telemedicina / Acessibilidade aos Serviços de Saúde / Pesquisa sobre Serviços de Saúde Tipo de estudo: Evaluation_studies / Overview / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Health Serv Res Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Austrália