Professional telephone advice to parents with sick children: time for quality control!

OBJECTIVE: To assess the quality of professional telephone advice given to parents with sick children. METHODS: All hospitals with an emergency department and a paediatric ward and a designated child health telephone advice line in the greater Brisbane region were invited to participate in the study. Case scenarios involving a febrile baby, a 14-month-old with gastroenteritis and an 18-month-old with a head injury were used three times with each institution. Each of the cases should have elicited a response indicating the need for urgent medical attention. A research assistant presented the symptoms in accordance with the questions of the telephone advice-giver. Aspects of the call were recorded, including time between call made and access to advice-giver, profession of advice-giver, identifying details sought by advice-giver, questions asked about the case presented, length of call, and advice-given. RESULTS: Of the 10 hospitals asked, six agreed to participate. Included in the study were two paediatric hospitals, two general public hospitals, one private hospital, and a Statewide-designated child health telephone advice line. Calls were generally attended to promptly. Only 37 (68.5%) of the advisers recognized the urgency of the case scenarios, with the febrile infant having the least likelihood of eliciting the correct advice (39%). Doctors gave more reliable advice than nurses in the fever scenario, but not in the other cases. CONCLUSIONS: Telephone advice to parents with sick children is easily accessible, but is often dangerously inappropriate. There is a need for tighter quality control and/or for a centralised telephone advice line to prevent inappropriate advice being given to parents.