Emergency department telephone advice: A survey of Australian emergency departments

Objective To ascertain the nature and extent of telephone advice to the public provided from the emergency department. Method A postal survey of all emergency departments in Australia (n=147). Results An 88% response rate was achieved. Sixty seven percent of emergency departments provide telephone advice. Seventy five percent of Directors of Emergency Medicine consider telephone advice to be worthwhile. The mean number of calls received each month is 627 per emergency department (range 4-12,500). Only 24% of emergency departments provide training on telephone advice. Fifty nine percent of departments do not document the calls. The general impression was that providing telephone advice was time consuming and distracted emergency department staff from direct patient care. Lack of funding to provide a dedicated service was frequently commented upon. The survey data indicated that there are at least 27.6 calls per 100 emergency department attendances; i.e. for every 100 attendances, there are a further 27.6 occasions of service. Conclusions The provision of telephone advice from emergency departments is common practice in Australia and appears to be ad hoc. This service has a particular advantage for those who have difficulty accessing medical care. More formalised systems should be established. This would relieve a considerable burden from emergency departments freeing resources for direct patient care.