THU0697-HPR CONTENT OF AND RHEUMATOLOGISTS’ AND NURSES’ OPINIONS ON A NURSE-LED TELEPHONE HELPLINE
Authors: Mehmet Elmacioglu, Natalia Westerman, Debby Vosse, Annelies Boonen, Yvonne van Eijk-Hustings
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> To improve timely response to patients' questions and to support that care is provided by the appropriate professional, a nurse-led rheumatology telephone helpline was introduced in May 2015. Different organisational approaches have been tried out to ensure an effective as well as efficient service. Currently a voicemail system is used. A selection menu allows patients to select whether he/she needs 1) advice regarding disease complaints, 2) drug prescriptions, 3) (change in) appointment at the clinic, 4) laboratory forms. Although the menu differentiates between requests, organising timely responses by the appropriate professional remains a challenge. Clear and joint definitions by the rheumatologists and nurses on what questions to what extent should be addressed by whom, are necessary. <h3>Objectives</h3> To facilitate further improvement of the helpline we explored 1) number and content of questions that were registered; 2) experiences of rheumatologists and nurses with the helpline; 3) opinions of rheumatologists and nurses on which questions should be answered via the helpline. <h3>Methods</h3> A file research explored the number of questions and reasons for contacting the helpline. Data were analysed descriptively. In semi-structured interviews among all rheumatologists (n=8) and nurses involved in manning the helpline service (n=6), experiences and opinions were explored. System Engineering Initiative Patient Safety (SEIPS) model, that focuses on system design and it's interaction with processes, and outcomes for patients, employees and organisation [1], was used to structure thematic coding of the transcripts. <h3>Results</h3> In 37 months, the helpline registered 3389 calls (see Table 1). A majority of the questions was about disease complaints (28.6%) or other related problems such as pain management, and exercise (27.8%). The proportion of requests for prescriptions was 21.8%. The interviews revealed that both rheumatologists and nurses considered the helpline valuable in providing easy access to care for patients with disease related questions. This should be the primary aim. The rheumatologists also valued their reduced workload, which occurred most if the knowledge of the nurse was sufficient to take care of the responses independently. Moreover, they valued if requests, such as prescriptions, were clustered by the nurses. The nurses experienced an increased workload. Sufficient knowledge on and training in rheumatology, and being familiar with the patient wee considered pivotal in providing appropriate and for the patient acceptable care. As nurses cannot precribe medication, the requests for prescriptions were considered inappropriate. Availability of protocols and guidelines were considered prerequisites by all for responding to patients' requests appropriately. <h3>Conclusion</h3> The helpline is used frequently and the selection menu has helped to gain insight in why the helpline is used by patients. There is consensus on the primary aim of the helpline and on prerequisites for nurse-led responses to patients' disease related questions. Rheumatologists and nurses have different opinions on some issues, such as the organisation of prescriptions. Our study findings can help in jointly improving consensus on the content of nursing care within the helpline. <h3>References</h3> [1] Carayon, P., et al. (2006). Work system design for patient safety: The SEIPS model. Qual Saf Health Care, 15(SUPPL. 1), 50–58 <h3>Disclosure of Interests</h3> Mehmet Elmacioglu: None declared, Natalia Westerman: None declared, Debby Vosse: None declared, Annelies Boonen: None declared, Yvonne van Eijk-Hustings Grant/research support from: UCB, Speakers bureau: Cellgene