Background
Methods
Design
Setting
Data collection and variables
Intervention
Randomization
Sample size
Intervention process evaluation
Statistical methods
Results
Population
Intervention group N = 5705 N (%) | Control group N = 5708 N (%) | |
---|---|---|
Gender, female | 3077 (53.9%) | 3101 (54.3%) |
Age in years | ||
0–5 | 1326 (23.2%) | 1292 (22.7%) |
6–18 | 964(16.9%) | 992 (17.4%) |
19–65 | 2677 (46.9%) | 2688 (47.1%) |
66+ | 738 (12.9%) | 732 (12.8%) |
DOW | ||
1, minimally worried | 521 (9.1%) | 559 (9.8%) |
2, a little worried | 1210 (21.2%) | 1207 (21.1%) |
3, somewhat worried | 2092 (36.7%) | 2016 (35.3%) |
4, very worried | 1118 (19.6%) | 1177 (20.6%) |
5, extremely worried | 764 (13.4%) | 749 (13.1%) |
Reason for encounter | ||
Somatic illness | 3046 (53.4%) | 3112 (54.5%) |
Somatic injury | 1044 (18.3%) | 1021 (17.9%) |
Psychiatric illness | 24 (0.4%) | 28 (0.5%) |
Othera | 223 (3.9%) | 224 (3.9%) |
Missing | 1368 (24.0%) | 1323 (23.2%) |
Day | ||
Weekday | 3463 (60.7%) | 3468 (60.8%) |
Weekend | 2242 (39.3%) | 2240 (39.2%) |
Time of the day | ||
Day (8–16) | 1889 (33.1%) | 1920 (33.6%) |
Evening (16–24) | 3076 (53.9%) | 3063 (53.7%) |
Night (00–8) | 740 (13.0%) | 725 (12.7%) |
Call-handler | ||
Nurse | 4444 (77.9%) | 4467 (78.3%) |
Physician | 1244 (21.8%) | 1222 (21.4%) |
Other (i.e. locum physician) | 17 (0.3%) | 19 (0%.3) |
Triage response and DOW
Triage responsea | Intervention group N = 5313 N (%) | Control group N = 5329 N (%) | OR (95% CI) |
---|---|---|---|
Telephone consultation | 2463 (46.4) | 2530 (47.5) | OR 1.05 (0.97–1.13) |
Face-to-face consultation | 2850 (53.6) | 2799 (52.5) |
Process evaluation
Quotes from the study | Sub-themes | Themes |
---|---|---|
I did not pay attention to the displayed DOW
| Structural problem in intervention | Intervention not received |
Another system was launched at the same time
| ||
It’s a forest of information on the screens
| Information overload | |
I feel that I might annoy the caller asking about their DOW
| Barriers towards DOW | Intervention not delivered |
I think we place too much responsibility on the caller with the DOW scale
| ||
By addressing something (DOW) we might leave out other questions
| ||
By using the DOW, we omit our professional approach
| ||
We already do this with our intuition
| DOW is intuitively recognized | |
We feel with our ears already
| ||
I feel the worry in the intonation, speed of communication and choice of words
| ||
I’m pretty new in the game and it helps me make the clinical decision
| DOW is useful in clinical decision-making | Usefulness of the scale |
The DOW makes an off set for the pedagogic part of the triage process
| ||
It can support my telephone consultation but just that
| DOW is useful | |
It can be used as a safety net and can be used for obtaining more information
|