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Article
Publication date: 27 November 2019

Mike Brady

Telephone triage or hear and treat (H&T) describes the process of UK ambulance services nurses and paramedics undertaking enhanced telephone assessments of patients to determine…

Abstract

Purpose

Telephone triage or hear and treat (H&T) describes the process of UK ambulance services nurses and paramedics undertaking enhanced telephone assessments of patients to determine the most appropriate response, which can sometimes result in no ambulance being sent. Given, however, that 999 is not considered an advice service, it may be reasonable to assert that the expectation of those calling 999 is always an immediate ambulance response. This may not always be realised and may affect patient experience. The purpose of this paper is to ascertain the following: to what extent are the views of UK ambulance telephone triage service users being gathered? In answering this research question, this review also aims to explore the findings to determine service users’ expectations of ambulance telephone triage and the possibility that these expectations are influenced by the UK media. The findings of which could be used to inform the need and nature of future research.

Design/methodology/approach

Phase one consisted of a computerised literature search of online databases CINAHL, Pubmed, Science Direct, Cochrane library, Web of Science and UK government-funded databases. Phase two consisted of searches of all UK ambulance services websites and the submission of freedom of information requests. Phase three consisted of a computerised literature search of the ProQuest international news-stream database.

Findings

A total of 78 results were identified and after further screening 34 results were excluded, leaving 44 for final review. The extent to which users experience of ambulance service telephone triage are being gathered is low; and often limited to one off pieces of non-peer reviewed work. Patients felt overall that they were treated with respect, dignity and care. However, being listened to, reducing anxiety and a need for prompt assurances remain important to those whose overriding expectation is that an ambulance should attend every time a 999 call is made. There appears to be a balanced media portrayal of H&T with the UK media. However, unrealistic public expectations represent a significant barrier to providing sustainable care that users consider to be of high quality.

Research limitations/implications

Some user experiences may have been gathered in more broad research exercises which explored various aspects of 999 ambulance service experience. This was not included if it could not be clearly differentiated as being related to H&T and thus may have resulted in data being omitted. It was not possible to systematically search social media platforms (such as facebook or twitter) for any media results related to this search strategy; only traditional print and online media platforms. This also may have resulted in data being omitted. The inclusion of non-peer reviewed research results and grey literature represents a possible limitation to the conclusions drawn within this review. The concept of Insider Research Bias cannot be ignored within this review. The author himself practices in telephone triage within a UK ambulance service; however, this insider bias is mitigated by the clearly articulated systematic methodology and use of the Critical Appraisal Skills framework. In a similar vein, reviews of this nature are also often conducted as part of a team, to reduce bias, increase objectivity and ensure the validity of findings. This review was a sole effort, and while this is not uncommon, there were no cross checks by peers of the search terms, strategy, paper selection, exclusion criteria or data extraction. This lack of peer critique is considered a possible limitation in mitigating selection and reviewer bias.

Practical implications

The results of this review would suggest a need to increase the amount of research and patient feedback gathered from those being assessed and managed by ambulance service telephone triage within the UK. Ambulance services could hold regular monthly small-scale qualitative interviews with patients and families to ascertain their views, perceptions and anxieties which can then provide an up-to-date understanding of user expectations and the health educational needs of local communities. Patient feedback received directly to ambulance services or via the Patient Advice and Liaison Service could be retrospectively analysed by researchers to determine key themes of positive practice or negative patient experience. Such feedback can be tracked through time and be used as a pre and post community intervention measure, to determine any changes. Moving forward, nationally standardised research frameworks should be adopted to provide more easily collated local and national data, which can monitor improvement strategies and provide a comparison between services to aid the sharing of best practice principles.

Originality/value

There is no other piece of work published which has reviewed the data in this area of clinical practice within the UK.

Details

International Journal of Emergency Services, vol. 9 no. 2
Type: Research Article
ISSN: 2047-0894

Keywords

Article
Publication date: 13 June 2016

Elisabeth Assing Hvidt, Thomas Ploug and Søren Holm

Telephone crisis services are increasingly subject to a requirement to “prove their worth” as a suicide prevention strategy. The purpose of this paper is to: first, provide a…

Abstract

Purpose

Telephone crisis services are increasingly subject to a requirement to “prove their worth” as a suicide prevention strategy. The purpose of this paper is to: first, provide a detailed overview of the evidence on the impact of telephone crisis services on suicidal users; second, determine the limitations of the outcome measures used in this evidence; and third, suggest directions for future research.

Design/methodology/approach

MEDLINE via Pubmed (from 1966), PsycINFO APA (from 1967) and ProQuest Dissertation and Theses (all to 4 June 2015) were searched. Papers were systematically extracted by title then abstract according to predefined inclusion and exclusion criteria.

Findings

In total, 18 articles met inclusion criteria representing a range of outcome measures: changes during calls, reutilization of service, compliance with advice, caller satisfaction and counsellor satisfaction. The majority of studies showed beneficial impact on an immediate and intermediate degree of suicidal urgency, depressive mental states as well as positive feedback from users and counsellors.

Research limitations/implications

A major limitation pertains to differences in the use of the term “suicidal”. Other limitations include the lack of long-term follow-up and of controlled research designs. Future research should include a focus on long-term follow-up designs, involving strict data protection. Furthermore, more qualitative research is needed in order to capture the essential nature of the intervention.

Originality/value

This paper attempts to broaden the study and the concept of “effectiveness” as hitherto used in the literature about telephone crisis services and offers suggestions for future research.

Details

Mental Health Review Journal, vol. 21 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 1 January 1991

Roberta L. Tipton

The American Telephone and Telegraph (AT&T) divestiture and the resulting changes in telephone company regulation in the United States have allowed telephone companies to…

Abstract

The American Telephone and Telegraph (AT&T) divestiture and the resulting changes in telephone company regulation in the United States have allowed telephone companies to diversify into non‐regulated businesses including the online information services industry. How and when US telephone companies enter potential information markets is determined in large part by the changes in regulation that have occurred and will occur over the next few years.

Details

Online Review, vol. 15 no. 1
Type: Research Article
ISSN: 0309-314X

Article
Publication date: 13 March 2009

Godfred Frempong

Emerging literature from developing countries speak volumes of innovative application of mobile telephones to support the economic activities of the micro and small enterprises

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Abstract

Purpose

Emerging literature from developing countries speak volumes of innovative application of mobile telephones to support the economic activities of the micro and small enterprises (MSEs). Invariably the technology is improving the efficiency of these operatives and boosting their competitiveness. The purpose of this paper is to analyze the contributions of mobile telephones to the development of micro and small enterprises in less urban and rural areas of Ghana.

Design/methodology/approach

The methodology used was basically questionnaire administration and was augmented by focus group discussions to collect data from MSEs in six locations in the country. The sample size was 600 enterprises and the selection was based on the International Standard Industrial Code.

Findings

The majority of the respondents were positive about the impact of mobile telephones on their businesses in terms of ease of contact with customers and suppliers, reduced cost of transportation and profitability. However, there is the urgent need for the development of innovative services to meet the changing needs of the enterprises.

Originality/value

Generally, these findings will contribute to the emerging empirical evidence of the strategic role mobile telephones are playing in the economies of developing countries.

Details

info, vol. 11 no. 2
Type: Research Article
ISSN: 1463-6697

Keywords

Article
Publication date: 7 September 2012

Nicky Kime, Mima Cattan and Anne‐Marie Bagnall

This article aims to describe an evaluation of a national pilot programme of telephone support services for older people in England and Scotland and is focussed on organisational…

510

Abstract

Purpose

This article aims to describe an evaluation of a national pilot programme of telephone support services for older people in England and Scotland and is focussed on organisational outcomes.

Design/methodology/approach

The “Call in Time Programme” was funded by the national charity Help the Aged and comprised eight telephone support projects in different locations, managed by different voluntary or charitable organisations. Researchers used semi‐structured interviews and a Delphi questionnaire to obtain the views of project coordinators.

Findings

Although the projects were found to provide a much needed service for socially isolated and lonely older people, the study identified four key areas of concern: operational structure; promotion and publicity; recruitment of volunteers; referral processes. Project coordinators wanted more autonomy and the flexibility to respond to older people's needs. Projects were limited by restrictions imposed by funding bodies or services themselves.

Practical implications

Project coordinators recommended more local control over project finances, clear referral pathways linking voluntary and statutory bodies, long‐term funding involving project coordinators and older people in planning and delivery, more training for project coordinators, clear record keeping and a coordinated approach to promotion and publicity.

Originality/value

While other studies have highlighted the importance of user involvement, this study provides valuable evidence demonstrating that those responsible for managing and delivering telephone support services, and service users, are instrumental in decision making and planning processes. As organisations are streamlined in efforts to increase efficiency and effectiveness, there is a need for a wider cultural change in the way supportive programmes are viewed and funded.

Details

Quality in Ageing and Older Adults, vol. 13 no. 3
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 1 December 1997

Per Andersson and Bengt G. Mölleryd

A longitudinal case study of the diffusion and change of mobile telephony in Sweden highlights the effects on service distribution against the background of rapid technological…

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Abstract

A longitudinal case study of the diffusion and change of mobile telephony in Sweden highlights the effects on service distribution against the background of rapid technological development and deregulations in the telecommunications industry. The descriptive and explorative study advances a contextual‐historical and interorganizational network perspective on service channel change and retail evolution. Explores the service distribution consequences of the emerging, increased technological integration within telecommunications, between fixed and mobile telephony, and between telecommunications and information and computer technology. Argues that these technological changes and the move towards convergence of telecommunications and information technology functions are connected to important structural changes in the distribution channels for these services. Builds on a case study of the Swedish distribution network for mobile telephony and identifies a number of significant structural channel changes. Discusses the distribution network consequences of technological convergence, in terms of new emerging patterns of channel relations and in terms of new roles and role sets. Elaborates on some general business implications of the convergence of former independent telephone, cable and information technology services.

Details

International Journal of Service Industry Management, vol. 8 no. 5
Type: Research Article
ISSN: 0956-4233

Keywords

Article
Publication date: 1 February 1999

Kidnapillai Selvarajah

Discusses Sri Lanka’s deregulation of its telecommunication sector and how its government opened doors for private sector participation. Uses 7 Tables to aid in further…

Abstract

Discusses Sri Lanka’s deregulation of its telecommunication sector and how its government opened doors for private sector participation. Uses 7 Tables to aid in further explanation of how conditions were in helping the private sector operators, foreign investment, cellular mobile telephone operators, fixed access network operators and the interconnections of networks. Concludes Sri Lanka’s telecoms network needs major upgrading and development, but even so Sri Lanka is well on its way to being the Asia‐Pacific’s more progressive market member.

Details

info, vol. 1 no. 1
Type: Research Article
ISSN: 1463-6697

Keywords

Article
Publication date: 15 August 2008

Arno Wirzenius

The purpose of this paper is to describe how the objectives of telecommunications universal service have been achieved in Finland, largely without any formal universal service

Abstract

Purpose

The purpose of this paper is to describe how the objectives of telecommunications universal service have been achieved in Finland, largely without any formal universal service regulation.

Design/methodology/approach

The approach is a historical one, showing the evolution over time of service take‐up and use, as well as legislative changes. A range of people were interviewed with first‐hand knowledge of the development of Finland's telecommunications sector, and drew on a range of published data sources.

Findings

Fixed telephony is now used by a minority of households in Finland, having been superseded by mobile and broadband. The paper finds that the European framework, which Finland was required to adopt added no value to previous practices. The potential for any losses due to universal service to be financed by the state in fact has created an adverse investment incentive.

Originality/value

Since universal service has been a “non‐issue” in Finland, this is thought to be the first attempt to describe how universal service has in fact been achieved there. Besides displaying aspects of the Finnish experience that other countries could learn from, the paper raises a number of useful questions for policy makers.

Details

info, vol. 10 no. 5/6
Type: Research Article
ISSN: 1463-6697

Keywords

Article
Publication date: 1 February 1993

Geradine M. Kaman

Discusses the telecommunications infrastructure of the USA andissues surrounding its restructuring. Describes the role and impact ofbroadband Integrated Services Digital Network…

Abstract

Discusses the telecommunications infrastructure of the USA and issues surrounding its restructuring. Describes the role and impact of broadband Integrated Services Digital Network (ISDN) in applications development and the societal implications of this change. Points out that global development of broadband technologies makes personal access to multimedia applications possible and promotes new information‐sharing partnerships. Argues for an holistic, ethical approach to future development of ISDN.

Article
Publication date: 20 January 2023

Sally Thomas, Sophia Cotroneo, Daniel Pham, Rosemary Kalogeropoulos, Jonathan Tyler and Shalini Arunogiri

Many people with dual diagnosis present with social complexity that impedes service access. The role of social work support in such service navigation is poorly understood. This…

Abstract

Purpose

Many people with dual diagnosis present with social complexity that impedes service access. The role of social work support in such service navigation is poorly understood. This study aims to characterise client presentations to an Australian telephone-based social work alcohol and other drug (AOD) service navigation and linkage program, with consideration of presentation complexity compared between those clients who present with or without self-reported mental health (MH) concerns and a history of MH diagnoses, to identify differences in baseline characteristics, and linkage outcomes.

Design/methodology/approach

A retrospective audit was conducted of routinely collected clinical information from a six-month period, selected to capture the social and health challenges experienced during the mid-pandemic period (mid-2021) in Victoria, Australia, during which a number of lockdowns resulted in a reliance on telephone-based services. The audit focused on client and presentation characteristics, and compared clients with and without a history of co-occurring MH and AOD concerns.

Findings

It was found that three in four people accessing an Australian telephone-based AOD service navigation and linkage program presented with dual diagnosis. Individuals with dual diagnosis required more support from the service compared to those without a co-occurring MH disorder; but overall, were just as likely to achieve a successful linkage to services, when offered holistic, long-term social work support.

Originality/value

This study focused on the role of social workers in this service navigation program in supporting individuals with complexity. It also highlights the challenges in operationalising social complexity factors alongside clinical MH and AOD diagnoses, and points to the need for further research to guide future service development for this vulnerable client group.

Details

Advances in Dual Diagnosis, vol. 16 no. 2
Type: Research Article
ISSN: 1757-0972

Keywords

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