Care needs assessment of non-urgent ambulance missions performed by a telephone nurse

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Lecture hall F202 (Aapistie 5 B)

Topic of the dissertation

Care needs assessment of non-urgent ambulance missions performed by a telephone nurse

Doctoral candidate

Master of Health Sciences Petri Roivainen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu

Subject of study

Nursing Science

Opponent

Docent Heikki Paakkonen, University of Eastern Finland

Custos

Professor Maria Kääriäinen, University of Oulu

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Care needs assessment by telephone reduces the number of non-urgent prehospital emergency care missions and can lead to savings in the emergency medical services

The telephone care assessment (TCA) reduced the number of non-urgent tasks in emergency medical services (EMS) by a third, and patients were satisfied with the received service. As the number of non-urgent tasks decreases, EMS resources could be better allocated to the care of urgent emergency patients. The data can be found in the dissertation of Petri Roivainen, M.Sc., who is defending his dissertation at the University of Oulu.

The purpose of the doctoral research was to describe the care needs, use of healthcare services and patient satisfaction of non-urgent prehospital emergency patients referred to the telephone care assessment. Also, the use of EMS and TCA resources and the distribution of costs were studied.

Combining telephone care assessment and non-urgent emergency medical services is a new approach in Finland, and there is no research data available on its effects on prehospital task volumes, resources, costs or patient satisfaction.

The pilot of the study was carried out in the Kainuu Hospital District during March-April 2018. It involved 765 non-urgent prehospital emergency patients, who were referred to the telephone care assessment after the risk assessment made at the emergency response center instead of EMS.

The most common reasons for calling the emergency response center were unclear symptoms and worsened general condition, musculoskeletal symptoms, falls, as well as mental health problems and substance abuse. According to the study, the care needs of non-urgent prehospital emergency patients can be well assessed over the phone. Nearly one-fifth of patients were treated with telephone guidance and counseling, while less than one-fifth of patients could be referred to other social and healthcare services. The rest of the patients (63%) were treated with standard prehospital emergency care, and only about half of them required ambulance transport to follow-up care.

The increased contacts due to non-urgent matters to EMS and emergency units is an internationally recognized phenomenon in all welfare societies. In international studies, telephone care assessment has been shown to reduce the workload of emergency care. Finnish emergency response center personnel are not health care professionals, and they cannot therefore provide care needs assessment. In Finland, the 116117 -Medical Helpline has been launched, aiming to meet the acute needs of citizens with telephone guidance and counseling. However, the service is not used everywhere in Finland and has not been integrated into the operations of the emergency response center.

According to the dissertation, the integration of TCA into the 116117 -Medical Helpline, emergency response center operations and emergency medical service can increase patient satisfaction, generate savings and curb the rising costs of the emergency care service. In addition to savings, the workload of EMS may be reduced, allowing resources to be better allocated to the care of urgent emergency patients. According to the study, it would be possible to utilize the TCA service at least in part with the existing service structures.
Last updated: 26.4.2022