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Table 5 Assessment of percentage poor and relative risk (RR) of poor quality of health-related items for different triage professionals

From: Safety, efficiency and health-related quality of telephone triage conducted by general practitioners, nurses, or physicians in out-of-hours primary care: a quasi-experimental study using the Assessment of Quality in Telephone Triage (AQTT) to assess audio-recorded telephone calls

Health-related specific items (AQTT)

Triage professional

Not applicablea

(%)

Poor quality % (n)

RR for poor quality (95% CI)

Adjusted RRc poor quality (95% CI)

1: Collects information about locationb

GP

70.7

32.3 (40)

1

1

Nurse

60.9

28.0 (47)

0.87 (0.61–1.23)P = 0.43

0.91 (0.61–1.34) P = 0.62

Physician

65.1

23.4 (36)

0.72 (0.49–1.01) P = 0.10

0.75 (0.51–1.10) P = 0.142

2: Asks to speak to the patient when the caller has briefly described the situationb

GP

87.2

79.6 (43)

1

1

Nurse

85.8

54.1 (33)

0.68 (0.52–0.89)* P = 0.01

0.71 (0.51–0.98)* P = 0.04

Physician

83.9

73.2 (52)

0.92 (0.76–1.12) P = 0.40

0.94 (0.75–1.17) P = 0.57

3: Identifies and acts appropriately on signs that could be critical or life-threatening for the patient (signs of problems according to the ABCDE criteria)

GP

73.5

42.9 (48)

1

1

Nurse

69.5

36.6 (48)

0.85 (0.63–1.17) P = 0.32

0.74 (0.55–1.00) P = 0.05

Physician

68.3

55.0 (77)

1.28 (0.99–1.67) P = 0.06

1.31 (1.00–1.70)* P = 0.05

4: Identifies and uncovers problems, including symptoms and their development

GP

1.0

30.3 (127)

1

1

Nurse

0.5

19.9 (85)

0.66 (0.52–0.83)* P = 0.00

0.61 (0.47–0.80)* P = 0.00

Physician

0.2

34.1 (150)

1.12 (0.93–1.37) P = 0.24

1.09 (0.89–1.34) P = 0.39

5: Identifies and states the purpose of the patient’s call

GP

20.3

24.3 (82)

1

1

Nurse

19.3

19.0 (66)

0.78 (0.59–1.04) P = 0.09

0.76 (0.54–1.70) P = 0.12

Physician

19.1

28.3 (101)

1.16 (0.91–1.49) P = 0.24

1.14 (0.86–1.50) P = 0.37

6: Prioritises the presented problems and symptoms in an appropriate way

GP

1.2

27.5 (115)

1

1

Nurse

0.5

25.9 (111)

0.94 (0.75–1.18) P = 0.0.60

0.81 (0.63–1.03) P = 0.8

Physician

1.8

37.6 (163)

1.37 (1.12–1.67)* P = 0.00

1.28 (1.05–1.57)* P = 0.02

7: Asks, as a minimum, all the essential questions concerning the problem(s) and symptom(s) required for optimal triage

GP

0.5

35.9 (151)

1

1

Nurse

0.0

27.7 (119)

0.77 (0.63–0.94)* P = 0.01

0.74 (0.59–0.93)* P = 0.01

Physician

1.1

43.8 (191)

1.22 (1.03–1.44)* P = 0.02

1.20 (1.01–1.42)* P = 0.04

8: Asks the relevant questions concerning previous medical history and medications

GP

32.2

49.5 (142)

1

1

Nurse

24.0

40.4 (132)

0.82 (0.68–0.97)* P = 0.02

0.75 (0.61–0.91)* P = 0.00

Physician

28.3

59.2 (187)

1.20 (1.03–1.39)* P = 0.02

1.15 (0.98–1.34) P = 0.09

9: Gives relevant advice on self-care

GP

34.0

29.8 (83)

1

1

Nurse

52.1

35.0 (72)

1.17 (0.91–1.52) P = 0.22

0.93 (0.71–1.22) P = 0.60

Physician

38.6

42.1 (114)

1.41 (1.13–1.78)* P = 0.00

1.30 (1.03–1.64)* P = 0.03

10: Gives relevant advice on safety netting

GP

36.9

40.5 (108)

1

1

Nurse

55.4

34.4 (66)

0.85 (0.67–1.08) P = 0.20

0.75 (0.58–0.97)* P = 0.03

Physician

41.7

40.9 (105)

1.01 (0.82–1.24) P = 0.93

0.98 (0.79–1.20) P = 0.81

  1. The RR for “poor quality” (i.e. “1” or “2”) was analysed using binomial regression model (GP as reference group). *Significant differences: p < 0.05
  2. aNot applicable was expected in a considerable proportion of cases, in line with the instructions for assessment in the guideline (see methods). We calculated the percentage of calls with “poor quality” (i.e. rated “1” or “2”) of all calls in which the item was relevant (i.e. “not applicable” excluded). bItems 1 and 2 were rated from “1” to “3”;
  3. c RR of poor quality adjusted for evaluator background (GPC, MH-1813) (i.e. if call is assessed by an assessor with the same professional background and organisation (similar-to-me)) and the uneven constitution of assessors (ratio assessors from GPC:MH-1813 – 16:8)