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Appropriate hospice palliative care is important to support individuals with life limiting illness who wish to stay at home. Afterhours (24/7) telephone helplines are often utilised to help provide at-home patients with way to contact their health care providers. Chong and colleagues (2022) conducted a research study to better understand factors associated with calls to better inform helpline service customization and resource allocation to optimise care.
An afterhours telephone line is not only beneficial to patient but also to caregivers as it may help in dealing with anxiety and stress caused by sudden changes in the condition of the seriously ill patient (Worth et al., 2006). An Afterhours telephone service is considered to be a lifeline to patients choosing to stay at home as this is exactly how most services are provided out of regular working hours (Chong et al., 2022).
The study, conducted in Singapore, examined some of the common reasons associated with calling the afterhours telephone helpline. Researchers looked at patients receiving hospice care services at home and examined electronic medical records for the use of the afterhours telephone service. Patient demographics, the type of caller (e.g. client, child, partner, parent etc.), reason for call and outcome of call (e.g. no follow up, home visit conducted, patient admitted to hospice etc.) were captured. The following were identified through analysis of incoming calls:
1. A total of 5,273 calls were made to the afterhours helpline by patients, caregivers, and HCPs from January 1st, 2019, to December 31st, 2020.
2. 1 in 5 phone calls to the helpline were received after regular working hours.
3. Patients associated with afterhours calls appeared to be older and single in comparison to the non-calling group.
4. Of the incoming calls, 88.4% were made by caregivers and the rest were by healthcare workers, the patient themselves, live-in helpers, and other individuals.
5. Approximately 47% of all calls received were classified as urgent and almost 8% of all patients were hospitalized.
6. 65.1% of all patients who called the helpline received a follow-up by their primary care nurse.
The researchers also conducted a logistic regression to identify factors that predicted likelihood of the call’s urgency. The results included:
1. Younger patients were more likely to call for urgent issues.
2. Patients with preferred place of death other than home were more likely to make calls with urgent issues.
3. Calls from other healthcare workers or the patients themselves were less likely to be ‘urgent’ compared to callers who were patients’ children (son or daughter).
The authors concluded that an afterhours telephone helpline remains a vital part of hospice palliative care services. They noted that further training for health care providers and characterisation of patient and caller profiles can serve as a means for triage by staff receiving afterhours phone calls. Further, by better understanding factors associated with the call, the service can be redesigned to optimize resourcing to improve care.
Source: Chong, P.-H., Lee, J., Yeo, Z.-Z., & Ang, R. Q. (2022). Utilisation of after-hours telephone support in a home-based hospice service. BMC Palliative Care, 21(1), 159. https://doi.org/10.1186/s12904-022-01049-5
Worth, A., Boyd, K., Kendall, M., Heaney, D., Macleod, U., Cormie, P., Hockley, J., & Murray, S. (2006). Out-of-hours palliative care: A qualitative study of cancer patients, carers and professionals. British Journal of General Practice, 56(522), 6–13. https://bjgp.org/content/56/522/6
