Evaluation of Parental Phone Calls to Cardiac Services

Background:
Heart defects are the most common congenital anomaly in babies born in the UK. Standards set by NHS England (2016) state children with a confirmed cardiac abnormality will have ongoing access to a children’s cardiac specialist nurse telephone advice service for patients/families/carers. Currently there is little published information to describe the workload associated with ongoing support for families following discharge from hospital by Clinical Nurse Specialist (CNS) teams and other health care professionals (HCP).
Aim: to review phone calls received by HCP working in cardiac services in a tertiary children’s hospital from parents following discharge from hospital. To include: the number of calls, which service(s) received the calls, nature of queries and the time spent on telephone enquiries.
Method
A data collection tool to capture information about parent phone calls was developed, piloted and implemented for use with cardiac secretaries, two inpatient cardiac wards areas, cardiac outpatients department and Clinical Nurse Specialist (CNS) office (CNS and family support workers) (April-May 2019). The work was classed as service evaluation and registered on the organisation audit database. Data was entered into a secure database and analysed using descriptive statistics and thematic analysis.
Results
In a 3 week period 119 telephone calls were documented; 41% (n=49) received by CNS office, 28% (n=34) by secretaries, 18% (n=21) by cardiac ward staff and 13% (n=15) by cardiac outpatient department (OPD). In total (across all HCP groups) 11 hours of time was spent taking phone calls; 0.8hrs (OPD), 1.6 (ward staff), 2.6hrs (secretaries) and 6hrs (CNS). This did not include time to deal with any action required as a result of the calls. The biggest reason for phone calls related to appointments (n=27, * %) although the majority of these were appropriately directed to secretaries and medications 34 (*%). 15 calls related to repeat prescriptions or problems obtaining specialist medications and 14 concerned medication dose, duration and potential error.
Conclusion
HCP working across cardiac services experience a high volume of telephone calls from parents. Telephone calls associated with prescriptions, obtaining medications and medicine administration were prevalent. Further research is being conducted to identify the time implications of dealing with these phone calls, staff confidence in advising on these issues and families views on the discharge process.