Health helplines a good call

Triage telephone lines staffed by nurses are a convenient way for patients to get expert health-care advice they trust-with an added bonus of avoiding a trip to the emergency room.

According to research from the University of Alberta, seven out of eight patients who use Alberta's HEALTHLink 24/7 triage line follow the advice they receive.

"Much of my research in self-care is centred around education and increasing awareness so health-care professionals can incorporate self-care into their practice," said lead author Bev Williams, an associate professor in the Faculty of Nursing at the U of A. "It's an important, innovative tool for health care in Alberta, especially now with the pressures facing the system."

The study, which appears in the April issue of the Journal of Clinical Nursing, saw Williams' team interview 312 HEALTHLink callers to find out whether they followed advice given by teletriage nurses.

The vast majority of participants were women, at 92 per cent. About two-thirds of callers sought advice on behalf of someone else, with children the top response at 94 per cent. These types of inquiries most often focused on colds, flu, diarrhea, vomiting, infections, pregnancy and post-pregnancy.

Without teletriage, Williams said, callers would be left with little recourse but visiting an emergency department, potentially a very long proposition given the non-emergent nature of many calls. And for all too many Albertans without a family doctor, that route isn't an option, she said.

"The emergency department would probably be where most of these moms and children would end up. Certainly, in terms of the health-care system, emergency care or a family physician's office is far more costly than a telephone triage system would be."

In 73 per cent of cases, the telehealth nurse advised some form of self-care. The remaining 27 per cent also received self-care recommendations but were advised to follow up with a health-care professional if the problem persisted.

Whether patients opted to take nursing advice depended greatly on how satisfied they were with the interaction. Satisfied callers were four times more likely to engage in self-care, results Williams said were influenced by things like the nurse's clarity and demeanour along with the ease of the advice itself.

Other factors influencing self-care decisions included how strongly the nurse emphasized the importance of following the advice and whether the caller agreed with that advice.

"This demonstrates the importance of having well-trained nurses who are patient and responsive with callers," Williams said.

The researchers found that 98 to 99 per cent of all callers said they'd likely use HEALTHLink again.

Williams is now concentrating on a followup study to engage non-urgent emergency room patients and find out whether they're aware of HEALTHLink and potential self-care options. That work is expected to wrap up by the end of the year.

"It's possible these patients could be waiting in the ER when a phone call to HEALTHLink may have helped them deal with their issue. Raising awareness would prevent unnecessary visits to the ER."

Williams' first study was funded by the Social Sciences and Humanities Council of Canada. The work is another example of the U of A enhancing the health of Albertans and Canadians through leadership in health-care research and innovation.