VIDEO: Half of after-hours calls to endocrinology fellows are nonurgent

Many calls to endocrinology fellows are often not urgent and could be directed to the clinic, potentially reducing work burden on the on-call fellows, a review of one center’s call logs suggests.

Nearly half of all calls were not urgent, many were after hours, and refill requests constituted the most common reason the patient initiated contact, according to Uzma Mohammad Siddiqui, MD, who presented results of the call log review in a poster presentation at the annual meeting of the American Association of Clinical Endocrinologists.

The log review was part of a quality initiative intended to streamline care of patients to their primary endocrinologists whenever appropriate, according to Dr. Siddiqui, a second-year fellow at the University of Massachusetts Medical School in Worcester.

“A lot of these calls were happening after 6:00 p.m. until midnight, sometimes waking fellows up from their sleep,” Dr. Siddiqui said in an interview. “Fellows thought that these were disruptive to their personal life, and also it was causing frustration among patients when they were not able to reach their primary endocrinologists.”

On-call endocrinology fellows logged a total of 100 calls between July and August 2017. Of those calls, the fellows categorized 47% as nonurgent, Dr. Siddiqui reported.

About one-quarter of the calls came in between 8 p.m. and 3 a.m., with an average of 1.6 calls logged per 24-hour period. The actual average is probably higher, since fellows missed logging some calls during busy inpatient service days, the investigators said.

The most common reason for the calls, at 39%, was for refills of insulin, test strips, or noninsulin medication, which could have been directed to the clinic, according to Dr. Siddiqui and coauthors of the poster.

 

The rest of the calls were for insulin pump failure (9%), hyperglycemia (14%) or hypoglycemia (9%), concerns related to insulin regimen (9%) or thyroid-related medication (5%), requests for test results (4%), fever or rash reports (6%), and inpatient consults (5%).

To tackle the issue of nonurgent calls, Dr. Siddiqui and colleagues have been educating patients to call during work hours for test results, and to request refills 3 business days ahead of time. In addition, they are reminding providers to ask about refills during the clinic visit and to discuss with patients when an after-hours call because of blood glucose thresholds would be warranted.

Dr. Siddiqui and colleagues are now analyzing results of these initiatives to show to what extent they are reducing work burden on fellows and improving patient satisfaction.

“Even in the past 2-3 months, we have seen a significant improvement,” Dr. Siddiqui said.

“The patients get to speak to their primary endocrinologist and are happier with their care, because they have one provider, one person who’s answering their questions,” she added. “With this, we also reduced the burden of nonurgent calls, so the fellows have more personal time, are not getting disturbed in their sleep, and have less chances of being over worked or fatigued.”

Dr. Siddiqui reported no disclosures related to the presentation.

Many calls to endocrinology fellows are often not urgent and could be directed to the clinic, potentially reducing work burden on the on-call fellows, a review of one center’s call logs suggests.

Nearly half of all calls were not urgent, many were after hours, and refill requests constituted the most common reason the patient initiated contact, according to Uzma Mohammad Siddiqui, MD, who presented results of the call log review in a poster presentation at the annual meeting of the American Association of Clinical Endocrinologists.

The log review was part of a quality initiative intended to streamline care of patients to their primary endocrinologists whenever appropriate, according to Dr. Siddiqui, a second-year fellow at the University of Massachusetts Medical School in Worcester.

“A lot of these calls were happening after 6:00 p.m. until midnight, sometimes waking fellows up from their sleep,” Dr. Siddiqui said in an interview. “Fellows thought that these were disruptive to their personal life, and also it was causing frustration among patients when they were not able to reach their primary endocrinologists.”

On-call endocrinology fellows logged a total of 100 calls between July and August 2017. Of those calls, the fellows categorized 47% as nonurgent, Dr. Siddiqui reported.

About one-quarter of the calls came in between 8 p.m. and 3 a.m., with an average of 1.6 calls logged per 24-hour period. The actual average is probably higher, since fellows missed logging some calls during busy inpatient service days, the investigators said.

The most common reason for the calls, at 39%, was for refills of insulin, test strips, or noninsulin medication, which could have been directed to the clinic, according to Dr. Siddiqui and coauthors of the poster.

 

The rest of the calls were for insulin pump failure (9%), hyperglycemia (14%) or hypoglycemia (9%), concerns related to insulin regimen (9%) or thyroid-related medication (5%), requests for test results (4%), fever or rash reports (6%), and inpatient consults (5%).

To tackle the issue of nonurgent calls, Dr. Siddiqui and colleagues have been educating patients to call during work hours for test results, and to request refills 3 business days ahead of time. In addition, they are reminding providers to ask about refills during the clinic visit and to discuss with patients when an after-hours call because of blood glucose thresholds would be warranted.

Dr. Siddiqui and colleagues are now analyzing results of these initiatives to show to what extent they are reducing work burden on fellows and improving patient satisfaction.

“Even in the past 2-3 months, we have seen a significant improvement,” Dr. Siddiqui said.

“The patients get to speak to their primary endocrinologist and are happier with their care, because they have one provider, one person who’s answering their questions,” she added. “With this, we also reduced the burden of nonurgent calls, so the fellows have more personal time, are not getting disturbed in their sleep, and have less chances of being over worked or fatigued.”

Dr. Siddiqui reported no disclosures related to the presentation.

Many calls to endocrinology fellows are often not urgent and could be directed to the clinic, potentially reducing work burden on the on-call fellows, a review of one center’s call logs suggests.

Nearly half of all calls were not urgent, many were after hours, and refill requests constituted the most common reason the patient initiated contact, according to Uzma Mohammad Siddiqui, MD, who presented results of the call log review in a poster presentation at the annual meeting of the American Association of Clinical Endocrinologists.

The log review was part of a quality initiative intended to streamline care of patients to their primary endocrinologists whenever appropriate, according to Dr. Siddiqui, a second-year fellow at the University of Massachusetts Medical School in Worcester.

“A lot of these calls were happening after 6:00 p.m. until midnight, sometimes waking fellows up from their sleep,” Dr. Siddiqui said in an interview. “Fellows thought that these were disruptive to their personal life, and also it was causing frustration among patients when they were not able to reach their primary endocrinologists.”

On-call endocrinology fellows logged a total of 100 calls between July and August 2017. Of those calls, the fellows categorized 47% as nonurgent, Dr. Siddiqui reported.

About one-quarter of the calls came in between 8 p.m. and 3 a.m., with an average of 1.6 calls logged per 24-hour period. The actual average is probably higher, since fellows missed logging some calls during busy inpatient service days, the investigators said.

The most common reason for the calls, at 39%, was for refills of insulin, test strips, or noninsulin medication, which could have been directed to the clinic, according to Dr. Siddiqui and coauthors of the poster.

 

The rest of the calls were for insulin pump failure (9%), hyperglycemia (14%) or hypoglycemia (9%), concerns related to insulin regimen (9%) or thyroid-related medication (5%), requests for test results (4%), fever or rash reports (6%), and inpatient consults (5%).

To tackle the issue of nonurgent calls, Dr. Siddiqui and colleagues have been educating patients to call during work hours for test results, and to request refills 3 business days ahead of time. In addition, they are reminding providers to ask about refills during the clinic visit and to discuss with patients when an after-hours call because of blood glucose thresholds would be warranted.

Dr. Siddiqui and colleagues are now analyzing results of these initiatives to show to what extent they are reducing work burden on fellows and improving patient satisfaction.

“Even in the past 2-3 months, we have seen a significant improvement,” Dr. Siddiqui said.

“The patients get to speak to their primary endocrinologist and are happier with their care, because they have one provider, one person who’s answering their questions,” she added. “With this, we also reduced the burden of nonurgent calls, so the fellows have more personal time, are not getting disturbed in their sleep, and have less chances of being over worked or fatigued.”

Dr. Siddiqui reported no disclosures related to the presentation.