Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative.

Journal Article (Journal Article)

OBJECTIVE: To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. DESIGN: Descriptive pilot project. SETTING: Extended Care and Rehabilitation Center (ECRC), Durham VA Medical Center, Durham, North Carolina. PARTICIPANTS: Eight of 20 registered or licensed practical nurses and 4 of 6 geriatric medicine fellows voluntarily participated in this quality improvement project. MEASUREMENTS: In two 45-minute focus groups, participants were asked to discuss 3 open-ended questions related to telephone medicine. Comments were recorded during the discussions; topical themes were identified by the authors. RESULTS: Participant comments could be categorized into 4 domains describing the characteristics of nurses and physicians who practice the best telephone medicine: (1) provides the appropriate medical component of patient care; (2) appreciates contextual issues; (3) respects the other party's time and resources; and (4) possesses a collaborative attitude. The focus groups identified 5 quality improvement goals: (1) better nursing assessment and provision of patient information; (2) minimization of non-urgent calls after hours; (3) more decisive physician action (or explanation of inaction); (4) better physician familiarity with facility policies/logistics; and (5) better communication/paging system. The discussion format allowed nurses and physicians to identify and respond to potential barriers to improving quality in each area. CONCLUSION: Nurses and physicians appreciate unique aspects of long-term care telephone medicine and identify distinct barriers to improving practice. Interdisciplinary focus groups were a productive step toward understanding the telephone medicine experience in our facility and developing quality improvement interventions for both nurses and physicians.

Full Text

Duke Authors

Cited Authors

  • Whitson, HE; Hastings, SN; McConnell, ES; Lekan-Rutledge, DA

Published Date

  • September 2006

Published In

Volume / Issue

  • 7 / 7

Start / End Page

  • 407 - 411

PubMed ID

  • 16979082

International Standard Serial Number (ISSN)

  • 1525-8610

Digital Object Identifier (DOI)

  • 10.1016/j.jamda.2006.01.023


  • eng

Conference Location

  • United States