Outgoing initial healthcare facility follow-up call metrics and barriers within a single United States poison center

Specialists in poison information are responsible for following-up with exposure cases managed at healthcare facilities. However, the amount of time, call components, and barriers met when completing an initial healthcare facility follow-up call in which a large amount of data and clinical recommendations are shared is not well described. A retrospective observational study was conducted by randomizing healthcare facility initial follow-up calls from January to April 2022. One hundred and thirty calls that met the inclusion criteria were randomly selected. We recorded seven unique time intervals within each call. Day of the week, time of day, and variability amongst specialists in poison information were also assessed. Initial follow-up calls took a median of 7.2 min. Most (67%) follow-up calls were directed to emergency departments. Barriers to completion of calls were most commonly due to the healthcare reporter being busy (37%) and specialists in poison information being placed on terminal hold (30%). There was variability between specialists in poison information in the time for healthcare reporter to share data (<i>P</i> &lt; 0.0001), time for specialists in poison information recommendations (<i>P</i> = 0.0076), and total time (<i>P</i> = 0.0003). Variability exists amongst specialists in poison information during periods of information exchange, particularly when the healthcare reporter is providing information and subsequently when the specialist in poison information is providing recommendations. Barriers to completing calls centered around healthcare reporter being busy or the specialist in poison information being placed on a terminal hold. There was no correlation with the time or day of the week. With notable variability in these calls during periods of intense communication of data and treatment recommendations, there are likely opportunities for specialists in poison information and poison center directors to work together to address variability and overcome barriers to completing initial hospital follow-up calls. Further studies to evaluate variability amongst specialists in poison information are the next steps in understanding this complex topic.

毒物信息咨询专家（poison information specialists）负责跟进医疗机构中处置的中毒暴露病例。然而，针对需共享大量数据与临床建议的初始医疗机构随访电话这一工作环节，其耗时、通话构成要素及所遇障碍的相关描述仍较为匮乏。
本研究于2022年1月至4月期间，对医疗机构初始随访电话进行随机抽样，开展回顾性观察研究（retrospective observational study）。最终随机选取符合纳入标准（inclusion criteria）的130通电话作为研究样本。我们记录了每通电话内7个独立的时间区间，并评估了通话日期、时段以及不同毒物信息咨询专家间的操作差异。
初始随访电话的中位通话时长为7.2分钟。其中67%的随访电话拨打至急诊科。通话完成的主要障碍为：医疗机构上报人员繁忙（占比37%），以及毒物信息咨询专家被置于终端通话保持状态（占比30%）。
不同毒物信息咨询专家在多个环节的时长存在显著差异：医疗机构上报人员共享数据的时长（<i>P</i> < 0.0001）、专家给出临床建议的时长（<i>P</i> = 0.0076）以及总通话时长（<i>P</i> = 0.0003）均存在组间差异。在信息交换阶段，尤其是医疗机构上报人员提供数据、随后毒物信息咨询专家给出建议的环节，不同专家的操作时长差异尤为明显。
通话完成的障碍主要集中于医疗机构上报人员繁忙，或毒物信息咨询专家被置于终端通话保持状态，且通话时长与时段或日期无显著相关性。鉴于此类通话在数据与治疗建议密集沟通阶段存在显著差异，毒物信息咨询专家与毒物中心管理人员可携手合作，以改善该类差异并克服初始医院随访电话的完成障碍。后续可开展针对毒物信息咨询专家间差异的进一步研究，以深化对这一复杂议题的认知。