References
A nurse-led rheumatology telephone advice line: service redesign to improve efficiency and patient experience
Abstract
Background:
nurse-led telephone advice line (TAL) services have been endorsed by the Royal College of Nursing (RCN) and provide patients and their carers with expert advice and self-management strategies. Identified helpline shortfalls in one rheumatology TAL included a high number of inappropriate calls, calls not recorded in patients' records, and no formal process for assigning calls to nurses. Using RCN guidelines, the service was redesigned by specialist rheumatology nurses to address these issues.
Method:
troubleshooting sessions were used to identify solutions to shortcomings in the helpline processes. Following service redesign, nurse/user feedback was collated, and efficiency savings achieved from reducing face-to-face appointments were calculated.
Results:
the new TAL received fewer inappropriate calls, was received positively by staff and patients, and saved approximately £354 890 a year for the local clinical commissioning group.
Conclusion:
rheumatology nurses successfully improved a TAL using RCN guidance. The approach could be used by other trusts to improve patient helplines and contribute to the NHS drive for efficiency.
Musculoskeletal conditions affect around a quarter of the adult population and account for approximately 30% of GP consultations in England (NHS England, 2016). In 2011, musculoskeletal conditions were estimated to account for nearly £4.8 billion of NHS spending (NHS England, 2016). The prevalence of musculoskeletal disorders correlates with population age; consequently, the burden on primary and secondary care resources is predicted to increase as the UK population ages (Arthritis Research UK, 2017).
Nurse-led telephone helplines are increasingly being used to address demands on NHS services, and help fulfil patients' need to access relevant information and advice from health professionals (Twomey, 2000; Hughes et al, 2002; Shah et al, 2013; Shaw et al, 2013). Telephone helpline services may promote patient and caregiver empowerment and disease self-management, and, if used effectively, could help reduce the burden faced by NHS services (McDonald, 2014; Arthritis Research UK, 2017). For example, patients with long-term conditions reported that they would like a named contact for day-to-day queries, and that they thought this would reduce GP visits and hospital admissions (McDonald, 2014).
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