Background Rheumatology telephone advice lines have become an integral part of rheumatology outpatient activities in recent years, falling within the remit of the clinical nurse specialists (CNS) workload. In a review of our CNS activities, it became apparent that almost one third of their time was spent on the advice line, where messages were being retrieved from an answer phone and recorded manually. It also became clear that many calls received were not directly related to disease or treatment, but instead related to administrative and clerical issues. Furthermore, patients often complained that leaving an answer phone message was impersonal. In order to make the advice line more efficient and patient centred, an existing medicines information system (MiDatabank®) was modified in order to record, triage and manage telephone calls to the rheumatology advice line.
Objectives To develop an more effective method for capturing, processing and reviewing patient queries to the CNS patient advice phone line.
Methods The MiDatabank® software (COACS) was designed to enable pharmacists to record, manage and store medicine management queries. Working with COACS, we modified and developed the software to facilitate the development of a novel rheumatology enquiry line service In consultation with administrative clerical staff and patient representatives, we implemented a new method of handling advice line calls: with a senior medical secretary directly handling the calls at a designated time each day, with all calls outside this time recorded on answer phone. All calls were recorded in a secure database and then allocated to an appropriate member of staff for action.
Results A four month audit of the implementation of the new Rheumatology enquiry line demonstrated that the system had a substantial impact on the work practices of the rheumatology staff. Prior to the system being implemented, more than 160 calls were received by the advice line each week, with the return call time on average of between one and two weeks. Under the new system, on average 170 phone calls were received each week: of these, 40% of these calls were administrative or clerical in nature, not requiring any CNS action. Over half of all queries were resolved within 48 hours of the message being received, including the more complex, CNS queries, and 92% of CNS queries taking less than one week. Of note, over the review time period, there was a reduction in the number of patient complaints about the service.
Conclusions The development of the Rheumatology Telephone Line, supported by the MiDatabank® software, is a novel approach to managing the administrative burden of the rheumatology advice line. An initial audit has indicated that this is a more efficient and effective way of managing the telephone advice line, with a re-allocation of tasks from CNS to administrative staff allowing our specialist nurses to spend more time on essential clinical duties.
Acknowledgements This project has been part funded by the National Institute for Health Research LMBRU
Disclosure of Interest None Declared