Abstracts

Telephone triage is a major part of the role of the epilepsy nurse coordinator. Some calls are from patients, while others are received by a spouse or parent. A large portion of these calls includes: reporting seizures, requesting lab results, and difficulties with medications. Many times instructions are given to adjust medications based on lab results, seizures, or side effects reported. On many occasions the person calling is asked to call back and let us know how they are doing in relation to the instructions given. Unfortunately we do not always receive a call back with this information. Are family members more responsible than patients about calling back? A tracking system to follow up with patients on a timely basis when we did not hear back from them was initiated. This is important in order to improve health outcomes from interventions. The epilepsy coordinator is responsible for all phone calls for a team of 2 neurologists. All calls received during regular business hours were documented prospectively over a two-week period noting , 1. who called, 2. the purpose of the call, and 3. any directions that were given. All calls pertained to individuals with epilepsy. We did not include calls related to medication refill requests, appointments, scheduling monitoring admissions or calls that did not request a return call. We tabulated the number of calls from family members versus patients, and which group responded to the request to call back. Our intent was to establish better communication with all our patients and to identify which group required more of an effort to establish consistent and reliable communication. A total of 37 phone calls were analyzed with 13 calls for medication problems, 10 to report seizures and 14 for test results. 46% of calls received were by family members and 54% by a patient. Phone calls for test results that led to medication changes represented the largest return rate of calls as instructed with 38% from the family group and 36% from the patients. 50% of families were likely to call back, while 52% of the patients did not. An equal number of spouses called, however, 40% of wives called back versus 20% of husbands. There were more telephone calls from females with a return rate of 55% versus 38% of males that returned calls. 3 out of the 5 calls received from parents were not returned. When we called patients we did not hear from, some stated they planned on calling but they [quot]did not want to be a bother.[quot] It is important to know how patients are doing after therapy changes. The development of a tracking chart will enable us to reach out to each patient in a timely manner when they do not call back as instructed. Ensuring that health care provider recommendations are completed is essential to improve health outcomes.