Search

(1) The COVID-19 pandemic has had many consequences on health systems worldwide. In the Spanish health system, telephone-based consultations were coupled to in-person consultations. This type of consultation was mainly a challenge for the primary care teams, who had to assume the greatest load of care provision. The objective of the present study was to discover the satisfaction and perception of health professionals related to a training program on efficient communication based on high-fidelity simulation. (2) Methods: A cross-sectional descriptive study based on a convergent and parallel mixed method. The satisfaction and perception of 275 health professionals associated with COVID-19 training based on the structured communication model CERCAR© was analyzed. (3) Results: The assessment of the satisfaction with the training and methodology was high. With respect to the transfer of information, the participants gave a high score to the categories of consolidation of learning, applicability to their work, and benefits for the institution. The qualitative results supported these findings. (4) Conclusions: The training program and its virtual modality were well received, and had a high degree of transference. The application of active, online learning methodologies is a relevant format for continuous education.

Proficiency in client communications is now widely accepted as a significant requirement of veterinary student education, with numerous training systems in use and documentation of outcomes required for academic accreditation. Little information is available concerning communication training for veterinary house officers (interns and residents), despite the large number of new graduates who enter such programs seeking further training and mentorship. The majority of student communication training focuses on face-to-face interactions with clients and development of core communication skills. By contrast, veterinary house officers in specialty hospitals frequently communicate about cases with practitioner colleagues by telephone, to assess emergent and urgent referrals and follow up on shared cases. Successful telephone communication with these colleagues is a valuable skill to cultivate in novice interns. In this pilot study, self-reported veterinary intern confidence with communication skills improved after a telephone-based simulated referring veterinarian (RDVM) communications training experience. The use of simulated RDVMs, and telephone-based training, shows promise for incorporation into future training experiences of veterinarians at this level.

Background Phone calls between pharmacists and prescribers play an important role in resolving potential errors and other issues. Despite their importance in patient care, and sometimes causing frustration for pharmacists, there is little research on these calls. Objective To quantify how long calls between pharmacists and prescribers are, how often phone calls occur, why calls are made, and who is called. Method An observational study was conducted with 130.5 h observed in 11 community pharmacies over 8 weeks in Dunedin, New Zealand, recording information about all incoming and outgoing calls. Data captured included information on length, date, time, reason for call, pharmacy staff involved, health professionals involved, and the place being called. We also surveyed pharmacists' perceptions of this communication. Results Data on 95 phone calls was captured. The mean length was 110 s (95% CI 88-133), at an average of 0.7 calls per hour. The most frequent reasons for calling were clarifications and dose inquiries. Conclusion Calling prescribers is perceived as a frustrating; however the frequency of calls we observed was low, but some were long. The amount of time spent for pharmacist interventions may be reduced using alternative communication methods but these need further study.

International audience; Objectives: Telephone use correlates with quality of life, and is one of the most important expectations of cochlear implant candidates. The aim of the present study was to assess the benefit of a progressive intensive 18-session training program, conducted by telephone in cochlear implant recipients.Material and methods: Nine cochlear-implanted adults underwent telerehabilitation focused on telephone use, with before-and-after assessment of: auditory performance, on Lafon monosyllabic words and MBAA sentences in quiet, cocktail-party noise and by phone; telephone use, on ad-hoc surveys and number of calls per week; and quality of life on ERSA and APHAB questionnaires.Results: Before training, monosyllabic word comprehension was poorer by telephone than by direct voice (64±5.7% vs. 26±5.3%; P

Background Hospitals and other health care providers frequently experience difficulties contacting patients and their carers who live remotely from the town where the health service is located. In 2016 Nurse Navigator positions were introduced into the health services by Queensland Health, to support and navigate the care of people with chronic and complex conditions. One hospital in Far North Queensland initiated an additional free telephone service to provide another means of communication for patients and carers with the NNs and for off-campus health professionals to obtain details about a patient utilising the service. Calls made between 7am and 10pm, seven days per week are answered by a nurse navigator. Aim To report utilisation of the service by navigated clients and remotely located clinicians compared to use of navigators’ individual work numbers and direct health service numbers. We report the reason for calls to the free number and examine features of these calls. Methods Statistical analysis examined the call reason, duration of calls, setting from where calls originated and stream of calls. Interactions between the reasons for calls and the features of calls, such as contact method, were examined. Results The major reason for calls was clinical issues and the source of calls was primarily patients and carers. Clinical calls were longer in duration. Shorter calls were mainly non-clinical, made by a health professional. Setting for calls was not related to the reason. The most frequent number used was the individual mobile number of the NN, followed by the hospital landline. Although the free number was utilised by patients and carers, it was not the preferred option. Conclusion As patients and carers preferred to access their NN directly than via the 1800 number, further research should explore options best suited to this group of patients outside normal business hours.

Purpose To better understand the longitudinal risks and benefits of telephone disclosure of genetic test results in the era of multi-gene panel testing. Patients and Methods Adults who were proceeding with germline cancer genetic testing were randomized to telephone disclosure (TD) with a genetic counselor or in-person disclosure (IPD) of test results (i.e., usual care). All participants who received TD were recommended to return to meet with a physician to discuss medical management recommendations. Results 473 participants were randomized to TD and 497 to IPD. There were no differences between arms for any cognitive, affective or behavioral outcomes at 6 and 12 months. Only 50% of participants in the TD arm returned for the medical follow-up appointment. Returning was associated with site (p

Objective Telemonitoring of cardiac implantable electronic devices (CIEDs) has many advantages. However, telemonitoring involves clinical work that is often overlooked or considered a burden, such as the work performed during telephone contact with patients. The objective of this study was to scrutinize telephone calls to and from patients to understand the clinical workload in CIED remote monitoring. The focus was on time spent, type of work, and the content of telephone contact with patients. Methods A combined quantitative and qualitative observational study was conducted at a large CIED remote monitoring center. The unit ‘encounter’ was used to describe either a telephone call between patient and clinician and/or a complete review of a CIED data transmission. The time spent on different encounters was measured, the telephone call content was identified and described, and the different types of clinical work were described. Results A total of 260 encounters were analyzed. Encounters that involved patient telephone contact were more time consuming. Telephone calls were mostly about the home monitoring box, CIED transmission data, and symptoms. In most telephone calls, two or more topics appeared. Five types of clinical work were performed: inclusion work, coordination work, diagnostic work, education work, and comfort work. Inclusion work and diagnostic work were the dominant types. Discussion Patient telephone contact in CIED telemonitoring is typically described as a “burden”. This study unpacks the contents and functions of telephone calls between patients and clinicians and suggests that the function of telephone contact should be recognized as integral, rather than burdensome, to the clinical work in CIED telemonitoring.

Background Up to date patient data is a cornerstone of optimal safety and care, so admission to hospital requires transfer of data held in the community to secondary care. Despite the advent of electronic medical record systems such as Connecting Care and EMIS, the telephone remains the mainstay of communication. Methods A prospective cross-sectional quality improvement project was conducted to assess the time taken in telephone communication between primary and secondary care doctors and determine if access to the electronic shared system, Connecting Care, would improve efficiency. As part of normal junior doctor activity, fifty GPs were contacted between September 2015 and February 2016 to obtain medical data on patients admitted to UH Bristol. Time taken to contact each GP and the duration of the conversation was recorded. One hundred patient records were accessed using Connecting Care between October 2015 and February 2016 and the length of time taken to access information documented. Results Out of 50 phone calls 27 resulted in direct transfer to a GP with time to transfer ranging from 12 seconds to 19 minutes 51 seconds (mean 8 minutes 10 seconds, median 7 minutes 16 seconds). A total of 28 messages were left with the receptionist with 16/28 phone calls being returned and time taken for the call to be returned ranged from 34 minutes to 21 hours 3 minutes (mean 5 hours 50 minutes 4 seconds, median 4 hours). Information was available for 88/100 patient records accessed using Connecting Care with a mean duration to access information required of 1 minute 47 seconds. This was significantly shorter than the mean duration of conversation with GPs (4 minutes 22 seconds), mean total duration of telephone call and mean total duration of time to achieve aim of call with GP practices of 13 minutes 18 seconds and 2 hours 14 minutes 11 seconds respectively. Conclusions This study identifies areas of potential improvement in current methods of communication between primary and secondary care. Direct telephone contact will always have an important role in sharing information. However, access for secondary care doctors to electronic patient records, with patient consent and consideration for confidentiality, would improve efficiency and alleviate time pressures on both busy primary and secondary care doctors. This would have a positive impact on patient care and safety.

Çalışmada Çanakkale Cephesi'nde haberleşme hizmetleri araştırılmıştır. Bu amaca ulaşmak için post-pozitivist paradigma altında nitel araştırma yöntemlerinden doküman analizi tekniği kullanılmıştır. Yoğunluklu olarak Genelkurmay Askerî Tarih ve Stratejik Etüt Daire Başkanlığı Arşivi'ndeki belgelerden yararlanılmıştır. Modern haberleşme tarihi ile ilgili birkaç kitap ve birkaç makale var olsa da Çanakkale Harbi'nde haberleşme ile ilgili bilimsel bir çalışmaya rastlanmamıştır. Araştırma, beş bölüm olarak sunulmuştur. Osmanlı Devleti'nde modern haberleşmenin başlamasından kısaca bahsedildikten sonra Çanakkale Muharebelerine kadar muhabere hizmetlerinin nasıl yürütüldüğü aktarılmıştır. Haberleşmede esas olan teşkilat-malzeme-kadro bilgisi 'malzeme' başlığı altında kurgulanmıştır. Bunlar büro, santral ve levazım malzemeleri, teknik malzemeler, personel ve destekleyici unsurlardır. Savaşta bile olsa teşkilat yapılanmasındaki kadrolarda hem eleman hem de sahra postaları açısından artış gözlemlenmiştir.Muhabere hizmetlerinde dört temel çalışma paralel düzeyde sürmüştür. Öncelikle gerekli yerlere telefon ve telgraf santrallerinin kurulumu, haberleşme aktarım sistemi ve malzemeleriyle İstanbul Muhabere ve Muvasala Genel Merkezi'nden Akçay Körfezi'ni ve tüm Trakya Bölgesi'ni kapsayan askerî haberleşme ağı kurulmuştur. Haberleşme hizmetlerinde ikinci temel hizmeti oluşturan bakım-onarım ve gözetleme hizmetleri son derece titizlikle yürütülmüştür. Muhaberedeki bir yılı aşkın hizmete bakıldığında tüm elemanlar olağanüstü fedakarlıklar göstererek ne pahasına olursa olsun haberleşmeyi sağlamışlardır. Teknik anlamda haberleşme ağı ile ilgili birçok harita, kroki, şema ve listeler profesyonelce hazırlanarak hiçbir şey tesadüfe bırakılmamış olduğu gözlemlenmiş ve kayıt altına alınmıştır.Sonuç olarak seferberliğin ilanı ile birlikte Çanakkale Müstahkem Mevki Komutanlığının görevi devralmasından başlayarak 18 Mart 1915 zaferi ile sonuçlanan savunmadaki haberleşme hizmetleri çok başarılı bir sınav vermiştir. Yaklaşık sekiz buçuk ay süren kara muharebelerinde Gelibolu Yarımadasının kuzey ve güney bölümleri ile Rumeli ve Anadolu Yakasını da kapsayan haberleşme ağı her türlü fedakarlıkla mükemmele yakın hizmet vermiştir. 'Önce muhabere sonra muharebe' doktrini Çanakkale Muharebelerinde bir defa daha yaşanmış ve de başarılı olmuştur. In this study, communication services in Çanakkale front were investigated. In order to reach this aim, document analysis technique which is one of the qualitative research methods has been used under post-positivist paradigm. The documents of the General Staff Military History and Strategic Studies Department were used intensively. Although there are a few books and articles about the history of modern communication, there is no scientific study on communication about Canakkale War. The research is presented in five chapters.After the brief introduction of modern communication in the Ottoman Empire, how the communication services were carried out until Canakkale War were discussed. Organizational-material-cadre information, which is the basis of the communication, is structured under the title material. These are office, power plant and supplies, technical materials, personnel and supporting elements. Even in case of war, there has been an increase in both staff and field posts in the cadres of the organization structure. The three basic works in the communication services continued on a parallel level. Installation of telephone and telegraph plants in necessary places preemptively, a military communication network which is covering the Akcay Gulf and the entire Thrace region from the Istanbul Headquarters and Muvasala Headquarters by using communication transmission system and materials has been established. Maintenance and repair services, which constitute the second basic service in communication services, have been carried out with utmost care. Over a year of service, all the personnels showed extraordinary sacrifices and provided communication at all costs. Technically, many maps, sketches, schemes and lists related to the communication network have been prepared professionally and nothing has been left to chance and it has been observed and recorded.As a result, with the announcement of the mobilization, communicatinon services during the defense which is started from take over of Çanakkale Fortune District Command and resulted in the victory of 18 March 1915 passed a very successful test. The communication network covering the northern and southern parts of the Gallipoli Peninsula and the Rumelian and Asian sides of the Gallipoli Peninsula provided excellent service during the land battles which lasted about eight and a half months. First communication then battle doctrine has been experienced in Canakkale War and has been succesful again. 217

Более 140 лет назад был изобретен телефон – событие, которое не только ознаменовало начало новой эры в области электросвязи, но и коренным образом изменило жизнь всего человечества. Общепринято считать "отцом телефонии" А. Г. Белла. Однако мало кто знает имена многих ученых, и особенно отечественных, работы которых предшествовали этому изобретению, а также тех, кто довел телефонную технику до совершенства. Русские специалисты совершили немало важных открытий в телефонном деле. Приведенные в статье факты позволяют по-новому взглянуть на историю развития телефонии в России, правильно оценить роль личности и коллектива в техническом прогрессе, соотнести их с историей страны и мирового сообщества., More than 140 years ago, the telephone was invented an event that not only marked the beginning of a new era in telecommunications, but also radically changed the life of all mankind. It is generally accepted to be considered the “father of telephony” by A. G. Bell. However, few people know the names of many scientists, especially domestic, whose work preceded this invention, as well as those who brought telephone technology to perfection. Russian specialists have made many important discoveries in telephony. The facts cited in the article make it possible to take a new look at the history of telephony development in Russia, correctly assess the role of a person and team in technical progress and relate them to the history of the country and the world community.

Dear SirIt was interesting to see the focus on simulation-based teaching in the recent issue of Medical Teacher. As final year medical students at the University of Bristol, we have experienced a c...

Evidence from human medicine shows a rise in telephone communication in support of after-hours services and in providing medical advice, follow-up information, etc. While specific training programs are continuously being developed for human medical education, limited publications are available on training veterinary students in telephone communication. Presented is our method of introducing a telephone communication skills exercise to third-year veterinary students. The exercise progressed over three phases and currently follows the principles of the Calgary–Cambridge Guide. Challenges and improvements on implementing a telephone communication exercise are discussed. Within veterinary communication curricula, attention should be given to the specific communication skills required for successful telephone consultations. In the absence of visual nonverbal cues and prompts during a telephone interaction, communication skills must be applied with greater intent and attention to achieve an effective consultation outcome.

BACKGROUND: Automated telephone communication systems (ATCS) can deliver voice messages and collect health‐related information from patients using either their telephone's touch‐tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one‐way, non‐interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention. OBJECTIVES: To assess the effects of ATCS for preventing disease and managing long‐term conditions on behavioural change, clinical, process, cognitive, patient‐centred and adverse outcomes. SEARCH METHODS: We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled‐trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015. SELECTION CRITERIA: Randomised, cluster‐ and quasi‐randomised trials, interrupted time series and controlled before‐and‐after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods to select and extract data and to appraise eligible studies. MAIN RESULTS: We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty‐one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long‐term conditions, and seven studies for appointment reminders. We downgraded our certainty in the evidence primarily because of the risk of bias for many outcomes. We judged the risk of bias arising from allocation processes to be low for just over half the studies and unclear for the remainder. We considered most studies to be at unclear risk of performance or detection bias due to blinding, while only 16% of studies were at low risk. We generally judged the risk of bias due to missing data and selective outcome reporting to be unclear. For preventive healthcare, ATCS (ATCS Plus, IVR, unidirectional) probably increase immunisation uptake in children (risk ratio (RR) 1.25, 95% confidence interval (CI) 1.18 to 1.32; 5 studies, N = 10,454; moderate certainty) and to a lesser extent in adolescents (RR 1.06, 95% CI 1.02 to 1.11; 2 studies, N = 5725; moderate certainty). The effects of ATCS in adults are unclear (RR 2.18, 95% CI 0.53 to 9.02; 2 studies, N = 1743; very low certainty). For screening, multimodal ATCS increase uptake of screening for breast cancer (RR 2.17, 95% CI 1.55 to 3.04; 2 studies, N = 462; high certainty) and colorectal cancer (CRC) (RR 2.19, 95% CI 1.88 to 2.55; 3 studies, N = 1013; high certainty) versus usual care. It may also increase osteoporosis screening. ATCS Plus interventions probably slightly increase cervical cancer screening (moderate certainty), but effects on osteoporosis screening are uncertain. IVR systems probably increase CRC screening at 6 months (RR 1.36, 95% CI 1.25 to 1.48; 2 studies, N = 16,915; moderate certainty) but not at 9 to 12 months, with probably little or no effect of IVR (RR 1.05, 95% CI 0.99, 1.11; 2 studies, 2599 participants; moderate certainty) or unidirectional ATCS on breast cancer screening. Appointment reminders delivered through IVR or unidirectional ATCS may improve attendance rates compared with no calls (low certainty). For long‐term management, medication or laboratory test adherence provided the most general evidence across conditions (25 studies, data not combined). Multimodal ATCS versus usual care showed conflicting effects (positive and uncertain) on medication adherence. ATCS Plus probably slightly (versus control; moderate certainty) or probably (versus usual care; moderate certainty) improves medication adherence but may have little effect on adherence to tests (versus control). IVR probably slightly improves medication adherence versus control (moderate certainty). Compared with usual care, IVR probably improves test adherence and slightly increases medication adherence up to six months but has little or no effect at longer time points (moderate certainty). Unidirectional ATCS, compared with control, may have little effect or slightly improve medication adherence (low certainty). The evidence suggested little or no consistent effect of any ATCS type on clinical outcomes (blood pressure control, blood lipids, asthma control, therapeutic coverage) related to adherence, but only a small number of studies contributed clinical outcome data. The above results focus on areas with the most general findings across conditions. In condition‐specific areas, the effects of ATCS varied, including by the type of ATCS intervention in use. Multimodal ATCS probably decrease both cancer pain and chronic pain as well as depression (moderate certainty), but other ATCS types were less effective. Depending on the type of intervention, ATCS may have small effects on outcomes for physical activity, weight management, alcohol consumption, and diabetes mellitus. ATCS have little or no effect on outcomes related to heart failure, hypertension, mental health or smoking cessation, and there is insufficient evidence to determine their effects for preventing alcohol/substance misuse or managing illicit drug addiction, asthma, chronic obstructive pulmonary disease, HIV/AIDS, hypercholesterolaemia, obstructive sleep apnoea, spinal cord dysfunction or psychological stress in carers. Only four trials (3%) reported adverse events, and it was unclear whether these were related to the interventions. AUTHORS' CONCLUSIONS: ATCS interventions can change patients' health behaviours, improve clinical outcomes and increase healthcare uptake with positive effects in several important areas including immunisation, screening, appointment attendance, and adherence to medications or tests. The decision to integrate ATCS interventions in routine healthcare delivery should reflect variations in the certainty of the evidence available and the size of effects across different conditions, together with the varied nature of ATCS interventions assessed. Future research should investigate both the content of ATCS interventions and the mode of delivery; users' experiences, particularly with regard to acceptability; and clarify which ATCS types are most effective and cost‐effective.

Aim To determine which aspects of primary nurse-patient telephone communication are viewed positively or negatively in terms of meeting the older persons’ needs. Background Health professionals are increasingly being called on to develop different ways of working and increase their capacity to meet the needs of an ageing population. In some countries telephone communication between primary nurses and patients in General Practice is already seen as a routine practice, but determining the value of this type of communication as a specific health service needs more understanding. Design A qualitative exploratory study as the aim was to explore the older person's experiences. Methods Semi-structured interviews were conducted with 21 older people from General Practices in New Zealand during 2014-2015. Thematic analysis was informed by a constructivist grounded theory approach. Findings The overarching theme was the difficulties older people face in making decisions about whether to contact a health professional by telephone and whether this should be the Primary nurse. Accounting for some of their symptoms as age related added to the uncertainty of decision making. Importantly some older people were not raising concerns e.g. emotional state. Conclusion Decision making by older people around treatment seeking is complex. Increasing the awareness of the nurse role in the General Practice is integral to creating a health system which will meet the needs of a growing older population. Primary care practices can review their systems to better inform older people how the nurse telephone role as a specific health service works and what they can expect when using this service. This article is protected by copyright. All rights reserved.

With an increasing demand for genetic services, effective and efficient delivery models for genetic testing are needed.In this prospective single-arm communication study, participants received clinical BRCA1/2 results by telephone with a genetic counselor and completed surveys at baseline, after telephone disclosure (TD) and after in-person clinical follow-up.Sixty percent of women agreed to participate; 73% of decliners preferred in-person communication. Anxiety decreased from baseline to post-TD (p=0.03) and satisfaction increased (p0.01). Knowledge did not change significantly from baseline to post-TD, but was higher post-clinical follow-up (p=0.04). Cancer patients had greater declines in state anxiety and African-American participants reported less increase in satisfaction. 28% of participants did not return for in-person clinical follow-up, particularly those with less formal education, and higher post-disclosure anxiety and depression (p0.01).Telephone disclosure of BRCA1/2 test results may not be associated with negative cognitive and affective responses among willing patients, although some subgroups may experience less favorable responses. Some patients do not return for in-person clinical follow-up and longitudinal outcomes are unknown.Further evaluation of longitudinal outcomes of telephone disclosure and differences among subgroups can inform how to best incorporate telephone communication into delivery of genetic services.

BRCA1/2 test disclosure has, historically, been conducted in-person by genetics professionals. Given increasing demand for, and access to, genetic testing, interest in telephone and Internet genetic services, including disclosure of test results, has increased. Semi-structured interviews with genetic counselors were conducted to determine interest in, and experiences with telephone disclosure of BRCA1/2 test results. Descriptive data are summarized with response proportions. One hundred and ninety-four genetic counselors completed self-administered surveys via the web. Although 98% had provided BRCA1/2 results by telephone, 77% had never provided pre-test counseling by telephone. Genetic counselors reported perceived advantages and disadvantages to telephone disclosure. Thirty-two percent of participants described experiences that made them question this practice. Genetic counselors more frequently reported discomfort with telephone disclosure of a positive result or variant of uncertain significance (p < 0.01) than other results. Overall, 73% of participants reported interest in telephone disclosure. Many genetic counselors have provided telephone disclosure, however, most, infrequently. Genetic counselors identify potential advantages and disadvantages to telephone disclosure, and recognize the potential for testing and patient factors to impact patient outcomes. Further research evaluating the impact of testing and patient factors on cognitive, affective, social and behavioral outcomes of alternative models of communicating genetic information is warranted.

The purpose of this project was to evaluate the incorporation of a telephone communication exercise into the junior surgery laboratory at Washington State University. Subjectively, the communication component seemed to encourage greater student preparedness and participation or ownership of cases in the surgical laboratory. Simulated clients were asked to score students on specific tasks and give any specific feedback. Students evaluated themselves on identical material. Areas of communication most likely to result in disparity of scores between the client's evaluation and the student's self-assessment were related to the patient's aftercare. Student survey results were consistently positive in regard to the value of the telephone communications exercise. Communication training in the veterinary curriculum could benefit from identifying opportunities to further integrate client communication experiences into other courses or laboratory experiences.

Article-at-a-Glance Background Communication failure is a common root cause of preventable medical errors affecting hospitalized patients. A study was conducted to determine the reasons for calls made by nurses working on the general medical wards to on-call physicians from 6:00 p.m. to 7:00 a.m. Methods A retrospective review was performed of a random sample of 500 inpatients admitted to general medical wards at an urban public teaching hospital in Houston between January 1, 2000, and February 28, 2003. Results In 139 (47%) of 293 medical records there were 304 documented calls. The majority of calls (81%) took place between 6:00 p.m. and 2:00 a.m., with peak call volume between midnight and 2:00 p.m. Patients with one or more calls had an average of 2.2 calls during their stay. Ten categories accounted for 65% of all the nurse calls. In 44% of calls, physicians responded by ordering a medication. Discussion Communication between floor nurses and on-call physicians might be improved by several interventions. Because 10 reasons accounted for 65% of after-hours calls, protocols could allow nurses to resolve some acute problems without physician involvement. For example, appropriate standing orders (e.g., P.R.N. medications) may prevent some calls. In addition, sign-out procedures can be tailored to address common problems that are likely to require future telephone communication. With efforts to change error-prone systems, it seems prudent to focus on after-hours coverage.

International audience; La revue de l'infi rmière ● Février 2015 ● n° 208 Telephone and coordination of intensive care in hospital. Th e telephone is a central tool for the coordination of care in hospitals between the general wards and intensive care. Calls are short and frequent. Th ey concern a wide variety of issues handled in parallel with other activities. Th is research, carried out by a Swiss team, examines the practices of telephone communication in hospitals. Le téléphone est un outil central pour la coordination des soins à l'hôpital entre les services de soins généraux et les soins intensifs. Les appels sont brefs, fréquents. Ils concernent une grande diversité de questions traitées en parallèle à d'autres activités. Cette recherche, réalisée par une équipe suisse, examine les pratiques de communication téléphonique en milieu hospitalier.

Previous work showed that telephone communications while wearing military respirators degraded both word comprehension and recognition speed. In addition, electronic amplification of the speech diaphragm signal had shown no advantage to the extra hardware. This experiment was performed to test effects of different configurations of commercially available respirators on telephone communications accuracy and speed. Twelve pairs of subjects were separated into different rooms and communicated by telephone. Modified rhyme-test words were presented by computer to the speaker, who transmitted the word by telephone to the listener. During the first replication, subjects were given no instruction about telephone communications procedure. During the second replication subjects followed a communications protocol that instructed them when to move the telephone handset from their ears to their mouths. Results showed that the protocol uniformly improved communications accuracy without incurring any extra time penalty. Word comprehension was still twice as fast without a respirator as with a respirator. Accuracy with the protocol nearly equaled the no respirator control value for most respirators tested.

Amaç:Bu çalışmanın amacı, eğitim ve ev egzersiz programı verilen diz osteoartritli hastaların ayda bir kez telefonla aranmasının hastalık semptomları, fonksiyonel durum ve yaşam kalitesi üzerine etkilerini araştırmaktır.Materyal Metod:Çalışmaya Dokuz Eylül Üniversitesi Tıp Fakültesi Fizik Tedavi ve Rehabilitasyon Anabilim Dalı Polikliniği'ne başvuran ve primer diz osteoartriti tanısı konan 60 hasta alındı. Hastalar 10 cm'lik Vizüel Analog Skala (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)'in Türkçe versiyonu ve Short Form (SF)-36'nın Türkçe versiyonu kullanılarak değerlendirildi.Çalışmaya alınan tüm hastalara diz osteoartriti ile ilgili genel bilgiler verildi, eklem koruma teknikleri konusunda önerilerde bulunuldu, belirlenmiş ev egzersiz programı öğretildi. Hastalara bu egzersizleri günde iki kez, 10 tekrarlı olacak şekilde haftada 5 gün yapmaları önerildi. Hastalara ayrıca bu bilgileri ve önerileri içeren ve egzersizleri şematik olarak gösteren bir broşür verildi.Daha sonra hastalar randomize olarak iki gruba ayrıldı. Birinci gruptaki hastalardan başlangıçta eğitimi verilen ev egzersiz programına ve koruyucu önlemlere uymayı altı ay boyunca sürdürmeleri istendi. Bu gruptaki hastalarla ayda bir kez, yaklaşık iki dakikalık standart telefon görüşmesi yapıldı. Telefonda diz ağrısı sorgulandı, diz ağrısı ile ilgili basit öneri ve hatırlatmalarda bulunuldu, egzersiz yapıp yapmadıkları, egzersizle ilgili sorunları olup olmadığı ve başka soru veya sorunları olup olmadığı soruldu. İkinci gruptaki hastalardan başlangıçta eğitimi verilen ev egzersiz programına ve koruyucu önlemlere uymayı altı ay boyunca sürdürmeleri istendi.Hastalar altı ay sonunda kontrole çağrıldı ve VAS, WOMAC ve SF-36 ölçekleri kullanılarak tekrar değerlendirildi.Bulgular:Başlangıçta, SF-36 fiziksel fonksiyon skoru, fiziksel rol güçlüğü skoru ve fiziksel özet skoru grup I'de grup II'ye göre istatistiksel olarak anlamlı düzeyde yüksek, VAS ile değerlendirilen hareket ağrı skoru düşüktü.Her iki grupta yer alan hastalarda 6 ay sonunda VAS ile değerlendirilen ağrı, WOMAC ve SF-36 skorları açısından istatistiksel olarak anlamlı düzeyde düzelme gözlendi.Altı ay sonunda SF-36 ağrı, genel sağlık, sosyal fonksiyon, mental sağlık, fiziksel özet ve mental özet skorları grup I'de grup II'ye göre istatistiksel olarak anlamlı düzeyde yüksek olarak saptandı. Düzenli egzersiz yapma oranı da, grup I'de grup II'ye göre istatistiksel olarak anlamlı düzeyde yüksekti.Sonuç:Diz osteoartritli hastalarda eğitim, eklem koruyucu öneriler ve ev egzersiz programı etkilidir. Hastaların ayda bir kez telefonla aranması ağrı ve psikososyal fonksiyonların düzelmesine ek katkı sağlayabilir ve egzersize uzun dönem uyumu arttırabilir.Anahtar sözcükler: Diz osteoartriti, telefonla takip, eğitim, egzersiz Purpose:The purpose of this study is to investigate the effects of monthly telephone calls on symptoms, function and general health status of patients with knee osteoarthritis who were given an education about knee osteoarthritis and joint protection recommendations and a home based exercise program.Material Method:Sixty patients who applied to the Dokuz Eylül University Physical Therapy and Rehabilitation policlinic and diagnosed as knee osteoarthritis were included in the study. The patients were evaluated by visual analog scale (VAS) for their pain, Western Ontario McMaster Osteoarthritis Index (WOMAC) for knee pain, stiffness and functionality, Short Form-36 (SF-36) index for quality of life.Patients recieved information about knee osteoarthritis and joint protection recommendations, and given a home exercise program twice in a day for five days of the week for six months. They were also given a printed information about this recommendations and the exercises.Patients were randomly assigned to two groups. Group I recieved joint protection recommendations, exercise and monthly telephone calls for six months. The telephone calls took two minutes and done monthly. During the calls patients were asked whether they have knee pain, do exercise or not, given information and suggestions about the knee pain and exercises. Group II recieved joint protection recommendations and exercise, but not telephone calls, for six months.At the end of the six months, the patients in two groups reevaluated by visual analog scale (VAS), Western Ontario McMaster Osteoarthritis Index (WOMAC), quality of life index Short Form-36 (SF-36).Results:Before treatment, group I patients had significantly higher physical functioning, physical role difficulty and physical summary score of SF-36 and significantly lower movement painVAS than group II patients.In both groups, pain VAS, WOMAC and SF-36 scores significantly reduced after treatment.In group I, pain, general health, social function, mental health, physical summary score and mental summary scores of SF-36 were significantly higher than group II. Also group I patients exercised more regularly than group II patients.Conclusion:Patient education, joint protection recommendations and home based exercise program were effective in knee osteoarthritis. Monthly telephone calls may contribute additional improvements in pain and psychosocial function scores and increase adherence to exercises in patients with knee osteoarthrtitisKeywords: Knee osteoarthritis, telephone, education, exercise 74

Dört bölümden oluşan çalışmanın genel bilgiler başlıklı birinci bölümünde telekomünikasyon yoluyla iletişimin denetlenmesi tedbirinin tanımı, tedbirle ilgili kavramlar, tedbirin hukuksal niteliği, bağlantılı olduğu ilkeler, tarihsel gelişimi ve ikili tasnifi yapılarak konu ele alınmıştır.Türk hukukunda adli amaçlı iletişimin denetlenmesi başlıklı ikinci bölümünde; koruma tedbiri niteliği taşıyan yönüyle telekomünikasyon yoluyla yapılan iletişimin denetlenmesi tedbiri ele alınmıştır. Bu kapsamda; tedbirin amacı, kapsamı, koşulları ve icrası, elde edilen verilerin yok edilmesi, ilgilisine bildirimde bulunulması, başvurulan tedbir sonucu elde edilen verilerin ceza muhakemesi hukukundaki değeri ve özel kişiler tarafından iletişimin denetlenmesi konuları ayrı başlıklar altında incelenmiştir.Türk hukukunda önleme amaçlı iletişimin denetlenmesi başlıklı üçüncü bölümde; meşruluğunu devletin, kişilerin ve toplumun güvenliğini, huzurunu sağlama görevinden alan ve idari nitelik taşıdığından idari kolluk birimlerince başvurulan önleme amaçlı iletişimin denetlenmesi tedbirinin tanım ve kapsamı, uygulanma koşulları, icrası, sona ermesi, tedbire başvurulması sonucu elde edilen verilerin kullanımı, tedbirin denetim şekilleri, hukuka aykırı olarak önleme amaçlı iletişimin denetlenmesi tedbirine başvurulması ile tedbir sonucu tesadüfen elde edilen verilerin akıbeti konuları ayrı başlıklar altında açıklanmıştır.Çalışmanın dördüncü bölümünde; iç hukukumuzun bir parçası haline gelen AİHS ve AİHM içtihatları bağlamında konu ele alınmıştır. Bu kapsamda, özel hayatın gizliliğini ve haberleşme hürriyetini güvence altına alan AİHS'nin 8. maddesinin uygulanma alanı, iletişimin denetlenmesi tedbiri bakımından getirdiği sınırlamalar, AİHM kararları ışığında sözleşmenin 8. maddesi ve telekomünikasyon yoluyla yapılan iletişimin denetlenmesi tedbiri ile bu bağlamda AİHM kararlarında telekomünikasyon yoluyla yapılan iletişimin denetlenmesi tedbiri bakımından aranan kriterler, iç hukukumuzda iletişimin denetlenmesi tedbiri bakımından getirilen düzenlemelerin AİHM'nin haberleşme hürriyetinin sınırlanmasında aradığı kriterleri teorik anlamda karşılayıp karşılamadığının analizi yapılarak konu ele alınmıştır. Çalışmanın sonuç kısmında ise; telekomünikasyon yoluyla yapılan iletişimin denetlenmesi tedbirine ilişkin olarak çalışma sonucunda elde edilen tespitler ile doktrinde tartışmalı konulara ilişkin görüşler özetle ortaya konulmuştur. This study is composed of four parts. In the first part named ?General Information?, the subject is approached by giving the the definition of the measure of interception of communication by telecommunication, the related concepts to the measure, the legal nature of the measure, the principals that the measure is related, historical development and the double classification of the measure.In the second part named ?Interception of Communication for Forensic Purpose under Turkish Law?, the measure of interception of communication by telecommunication is analyzed from the point of being a protective measure. In this context, purpose, scope, conditions and execution of the measure, abolishing the obtained data by applying the measure, informing the related parties about the measure, the value of the data that is obtained by the measure recoursed under the law of criminal procedure, and the interception of communication by private bodies are analyzed under separate titles.In the third part named ?Interception of Telecommunication for Preventive Purpose under Turkish Law, definition, scope, application conditions, execution and cease of interception of communication for preventive purpose that takes its legitimacy form the duty of protecting the security and the peace of the state, individuals and the community and since it has administrative character it is recoursed by the police forces, the usage of the data obtained from the application of the measure, the control methods of the measure, the illegal recourse to the measure and the legal status of the data incidentally obtained by application of the measure are analyzed under separate titles.In the fourth part of the study, the subject is approached from the points of European Convention on Human Rights (ECHR) that became the part of domestic law and the precedences of the European Human Rights Court (EHRC). In this context, the matter is discussed by analyzing the scope of the application of the Article 8 of the ECHR that protects the privacy of the private life and freedom of communication, the limitations set forth by Article 8 for interception of communication, the Article 8 and the measure of interception of communication by telecommunication in the light of the EHRC decisions, the criteria set forth by the EHRC for interception of communication, whether the domestic regulation regarding the interception of communication theoretically meets the criteria set forth by the EHRC for restricting the freedom of communication.In the conclusion part of the study, determinations reached at the end of the study regarding the measure of interception of telecommunication by telecommunication and the views regarding the disputed issues in the doctrine are introduced. 357

Errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Similarly, training in telephone medicine skills is limited; only 6% of residency programs teach any aspect of telephone medicine. Increasing familiarity with common telephone challenges with patients may help physicians decrease the likelihood of negative outcomes. We use case vignettes to highlight communication errors in common telephone scenarios. These scenarios include giving sensitive test results, requests for narcotics, managing ill patients who are not sick enough for the emergency room, dealing with late-night calls, communicating with unintelligible patients, and handling calls from family members. We provide management strategies to minimize the occurrence of these errors.

Multidisciplinary case conferencing using a video-link was compared with multidisciplinary case conferencing by telephone. One hundred patients were randomized to either videoconferencing (intervention group, 50 patients) or audioconferencing (control group, 50 patients). The effectiveness of the intervention compared with the control was evaluated in terms of: the number of conferences per patient, average length of conference, length of treatment, number of occasions of service, degree of multidisciplinary team involvement, recorded level of communication, quality of the management plan (in terms of the number of points contained in it) and staff satisfaction. The intervention and control groups showed significant differences on only two of the outcome measures: the mean number of case conferences per patient was less for the intervention group, and the intervention group had a shorter length of treatment (6 days) than the control group (10 days). The study did not demonstrate any significant differences in occasions of service or time commitment, which might have resulted in lower costs. However, the introduction of case conferencing by video-link was accompanied by a high level of satisfaction on the part of the 14 team members who were interviewed.

We investigated the telephone communication ability of patients with cochlear implants who could understand conversations in natural voice without difficulty. The hearing ability of those patients with telephone adapters, which usually are used to reduce noise level in the telephone and to record into a tape recorder, was also investigated. Vowel-confusion, consonant-confusion, and speech-tracking test results of patients listening to voices by telephone and by telephone adapter were compared with those of patients listening to natural, nontelephone voices. The average score of the speech-tracking test with natural voice was 111.5 phrases per 5 minutes. This score dropped to 62.4 by telephone. However, with a telephone adapter, the score of the speech-tracking test was 109.3 phrases per 5 minutes. This was almost the same score as that of the natural voice. So, generally speaking, the telephone communication ability of cochlear implant patients was not good enough. However, hearing ability with a telephone adapter came close to hearing ability during natural speech.

BackgroundTelephone communication is a challenge for many hearing-impaired individuals. One important technical reason for this difficulty is the restricted frequency range (0.3–3.4 kHz) of conventional landline telephones. Internet telephony (voice over Internet protocol [VoIP]) is transmitted with a larger frequency range (0.1–8 kHz) and therefore includes more frequencies relevant to speech perception. According to a recently published, laboratory-based study, the theoretical advantage of ideal VoIP conditions over conventional telephone quality has translated into improved speech perception by hearing-impaired individuals. However, the speech perception benefits of nonideal VoIP network conditions, which may occur in daily life, have not been explored. VoIP use cannot be recommended to hearing-impaired individuals before its potential under more realistic conditions has been examined. ObjectiveTo compare realistic VoIP network conditions, under which digital data packets may be lost, with ideal conventional telephone quality with respect to their impact on speech perception by hearing-impaired individuals. MethodsWe assessed speech perception using standardized test material presented under simulated VoIP conditions with increasing digital data packet loss (from 0% to 20%) and compared with simulated ideal conventional telephone quality. We monaurally tested 10 adult users of cochlear implants, 10 adult users of hearing aids, and 10 normal-hearing adults in the free sound field, both in quiet and with background noise. ResultsAcross all participant groups, mean speech perception scores using VoIP with 0%, 5%, and 10% packet loss were 15.2% (range 0%–53%), 10.6% (4%–46%), and 8.8% (7%–33%) higher, respectively, than with ideal conventional telephone quality. Speech perception did not differ between VoIP with 20% packet loss and conventional telephone quality. The maximum benefits were observed under ideal VoIP conditions without packet loss and were 36% (P = .001) for cochlear implant users, 18% (P = .002) for hearing aid users, and 53% (P = .001) for normal-hearing adults. With a packet loss of 10%, the maximum benefits were 30% (P = .002) for cochlear implant users, 6% (P = .38) for hearing aid users, and 33% (P = .002) for normal-hearing adults. ConclusionsVoIP offers a speech perception benefit over conventional telephone quality, even when mild or moderate packet loss scenarios are created in the laboratory. VoIP, therefore, has the potential to significantly improve telecommunication abilities for the large community of hearing-impaired individuals.

In response to a previous study of GPs' and consultants' satisfaction with orthopaedic outpatient referrals, orthopaedic surgeons at Doncaster Royal Infirmary made themselves available for telephone consultations with general practitioners (GPs) at advertised times. This service, called 'Boneline', was used infrequently, though the GPs who did use it found it valuable, and reported that a number of referrals had been avoided by speaking to the consultant. There was, however, no significant change in the rate at which requests for out-patient appointments were received during the six months of Boneline's operation. Opportunities for improving telephone communication between GPs and consultants are discussed.

Using patient-simulators is an effective and inexpensive approach for teaching telephone communication skills to health professionals. An audiotaped simulation program has been carried out with the residents of the Family Practice Center at the University of North Carolina at Chapel Hill and has been implemented in several other areas, including pediatrics, psychiatry, nursing, and a third-year elective clerkship in family medicine.

A survey of Massachusetts pediatricians and general practitioners and of telephone answering services indicated widespread use of the telephone answering service by physicians, but with some important differences between what physicians expect and what the services said they do. The importance of telephone communication is of such importance to practitioners that they should be as critical of their utilization of the answering service as of any other therapeutic tool.

The deaf currently communicate over the telephone network through the use of teletypes or CRT terminals. These aids, while of great benefit to individuals so equipped, do not permit communication with persons not owning special equipment. A device presented here provides telephone communication for the deaf without requiring special equipment at the hearing party's location. The aid operates via tones received from a standard Touch Tone (TM) telephone which greatly expands potential telephone usage for the deaf.

THE HARD-OF-HEARING patient often has communication problems that are not solved by the use of a hearing aid or by lipreading. Some of these problems involve the use of the telephone, radio, and television, and the inability to hear the door chime, telephone bell, and alarm clock. The solution to these problems can be frustrating not only to the patient but also to the otologist and audiologist whom he consults regarding them. The purpose of this paper is to familiarize the reader with some of the instruments that have been developed to solve these problems. All are available either through the telephone company business office or the patient's own hearing aid dispenser. Telephone Communication The telephone represents a major avenue of communication and one that offers the hard-of-hearing person considerable difficulty. Modern hearing aids often provide a telephone switch (Fig 1). Moving the switch turns off the aid's microphone and