Extrait

Background and study aims Patients often ring their surgeries asking for same-day consultations. Not all such patients want or need to see a doctor or nurse face-to- face on each occasion. Some people, such as those who work during the day or have caring responsibilities, may find it easier to get prompt advice over the phone, rather than having to visit the practice in person. This system of assessing how best to meet patients' needs is called 'telephone triage'. Our study looks at how telephone triage systems led by doctors and nurses work. We are particularly interested in how these systems affect patients' experiences, safety and health, as well as practices' workloads and costs. There is already some evidence illustrating the advantages and disadvantages of GP and nurse-led triage. However, much of this evidence is based on small samples. There has also not been a thorough comparison between GP and nurse led triage. Therefore, there is a real need for a large trial that directly compares these models of telephone triage for patients that are seeking a same day appointment. Who can participate? Any patient that calls the practice and asks to see a GP on the day of the call is eligible for the trial. Patients will be entered into the trial providing they are not too unwell and providing there is no language barrier. What does the study involve? Forty two GP surgeries across England have agreed to participate in the trial. They will be separated into three groups. One group will implement a GP triage model, with only GPs calling patients who have requested a same day appointment. A second group will implement a nurse triage model, with only nurses calling patients who have requested a same day appointment. The third and final group will 'carry on as usual' and form our usual care or control group. Patients who call up asking for a same day appointment will be asked by a clinician whether a researcher can have a look at their medical notes to see if they needed any further help or advice after their first contact. About four weeks after the same day appointment request has been made, patients will be sent a questionnaire asking for their feedback on their experience of care. The questionnaire will also ask patients how their health condition is currently and will also ask them to report their age, gender and ethnicity. What are the possible benefits and risks of participating? There should be some relatively immediate benefits to those patients who belong to a GP surgery that is in one of the triage groups - they may receive faster access to a clinician than they would do usually. The outcomes of the trial may make an important contribution to the way that same day appointments are managed in general practice. There may be future benefits to patients through the provision of better access to clinical care. There are unlikely to be any risks in taking part in this research. Where is the study run from? The ESTEEM study has been set up by the University of Exeter Medical School, The University of Bristol, The University of Warwick, and the University of East Anglia. When is the study starting and how long is it expected to run for? The main ESTEEM trial will start patient recruitment in April 2011 and will be completed by December 2012. All follow up work will be completed by the end of March 2013. Who is funding the study? The NIHR Health Technology Assessment Programme - HTA (UK). Who is the main contact? Prof John Campbell [email protected]

Critère d'inclusion

• Triage systems in GP practice

Liens

• isrctn
• ictrp