Understanding the Scale and Nature of Parent/Guardian Telephone Calls to a Tertiary Children's Cardiac Centre: A Service Evaluation.

Abstract

Heart defects are the second most common congenital anomaly in babies born in the UK and standards state families should have access to a children's cardiac nurse specialist telephone advice service. However, there is little published information to describe the nature of calls and the workload associated with telephone support. We conducted a prospective service evaluation of telephone calls received at one UK specialist children's cardiac surgical center from parents/carers (April-June 2019). All inpatient cardiac teams (cardiology secretaries, inpatient cardiac wards, outpatient department and Clinical Nurse Specialist team) were asked to record calls on a purpose-designed template. This included recording of call duration and reason (from pre-defined categories), with the aim to identify the volume and nature of phone calls. Actions and time taken to resolve issues were not recorded. Data was entered into Excel and analyzed using descriptive statistics. In a seven-week period, 204 telephone calls were received; 41% (n = 83) to the clinical nurse specialist team, 25% (n = 51) to medical secretaries, 20% (n = 42) to cardiac ward staff and 14% (n = 28) to the cardiac outpatient department. The mean length of calls was 6.08 mins (SD 5.07 mins). Across all groups phone call duration totaled 20.8 hours. Sixty-two calls (31% of all calls) reflected 70 concerns/queries about a current health issue. The most common reasons included respiratory (n = 13), heart rate or rhythm (n = 12) and chest pain/pallor (n = 11). Sixty-five calls (32% of all calls) related to issues surrounding medications, with 23% (n = 15) related to dose queries and 49% (n = 32) related to repeat prescription requests or challenges obtaining prescriptions. The results demonstrated a high telephone support need for current health issues or medication queries which required timely assessment and support from health care professionals working across cardiac services. Further research is required to identify the time implications of dealing with phone calls and interventions to support parent/guardian assessment and communication about their concerns and medication management.