Study: After-hours call screening may cause errors

A new study suggests that when patients call their physicians after hours or on weekends, it's better not to ask them to decide whether their problem is an emergency or not. The study, which appears in the Journal of the American Board of Family Medicine, suggests that asking patients to determine which concerns are urgent and which can wait until regular business hours can lead to serious complications. In fact, putting this responsibility on the patient's shoulders may be an under-recognized source of medical errors, the authors suggest. "A lot of times patients don't really know if it's an emergency or not," said lead author David Hildebrandt of the University of Minnesota department of family medicine in an interview with the Washington Post.

In their analysis, researchers led by Hildebrandt studied all 2,835 after-hours calls coming in to the University of Colorado's family medicine clinic between April 2000 and March 2001. The researchers found that 90 percent of the calls were referred to a physician because the patient said the matter was urgent. However, of the 10 percent of callers that did not consider their call urgent, several actually had potentially serious problems, including a woman leaking amniotic fluid, a man with chest pain radiating down his arm and another patient having trouble breathing. When researchers reviewed 119 of the calls that weren't forwarded, they found that three patients had been harmed by not reaching a physician, and that two were at risk for future harm. Perhaps more practices need to hire nurses to screen calls coming in after hours. Yes, it's not cheap to do so, but as this study demonstrates, nurse screeners could reduce error rates and prevent doctor burnout.

Learn more about the study:
- read this article in the Washington Post

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