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PloS one2020; 15(9); e0238874; doi: 10.1371/journal.pone.0238874

Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study.

Abstract: Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession. To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making. Participatory action research using mixed-methods approach. An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group and individual interviews were conducted with four equine client care (reception) teams on their experiences around telephone triage of colic. Evidence-based resources, including an information pack, decision flow chart and recording form, were developed and implemented within the practices. Participant feedback was obtained through interviews six months after implementation of the resources. There were 116 participants in the online survey. Management and client care staff (53/116) felt less confident giving owner advice (p<0.01) and recognising critical indicators (p = 0.03) compared to veterinary surgeons and nurses (63/116). Thirteen themes were identified in the survey relating to owner advice; exercise and owner safety were most frequently mentioned, but conflicting guidance was often given. Fourteen client care staff were interviewed. They were confident recognising colic during a telephone conversation with an owner and identified the most common signs of critical cases as sweating and recumbency. The new resources received positive feedback; the decision flow chart and information on critical indicators were identified as most useful. After resource implementation, there was an increase in confidence in recognising critical cases and giving owners advice. Limited sample population. This study described existing approaches to telephone triage, identified variations in advice given, and worked with client care teams to develop new resources to aid decision-making.
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Publication Date: 2020-09-23 PubMed ID: 32966300PubMed Central: PMC7510986DOI: 10.1371/journal.pone.0238874Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study investigates how UK veterinary practices handle telephone triage for horses with abdominal pain (commonly known as colic), providing new resources to improve the process using a Participatory action research approach.

Methodology and Demographics

This study used a mixed-methods approach consisting of online surveys, group and individual interviews, field testing of the developed resources, and follow-up interviews. The target audience was veterinary practitioners and staff who regularly use telephone triage for addressing cases of colic in horses.

  • The online survey had 116 participants, majority of whom were management and client care staff (53), with the rest being veterinary surgeons and nurses (63).
  • Four equine client care (reception) teams participated in group and individual interviews to share their experiences with telephone triage for horse colic cases.
  • An information pack, decision flow chart, and recording form were developed as evidence-based resources to support decision-making during telephone triage. These tools were implemented within the veterinary practices and tested in the field.
  • Follow-up interviews six months after the implementation of these resources collected feedback on their efficacy.

Findings

  • The study found that management and client care staff were less confident in giving owner advice and recognizing critical indicators of horse colic compared to veterinary surgeons and nurses.
  • Inconsistencies in advice and guidance given to horse owners regarding colic were observed, with thirteen themes identified in this regard. Exercise and owner safety were the most frequently mentioned topics during the telephone triage.
  • The client care teams were generally confident in recognizing horse colic during telephone conversations with owners, and identified sweating and recumbency as common signs of critical cases.

Impact of Implemented Resources

  • The newly developed resources, especially the decision flow chart and critical indicators information, were positively received and found useful in the telephone triage process.
  • After the resources were implemented, there was a notable increase in the confidence of veterinary staff in recognizing critical cases and giving advice to horse owners.

Conclusions

Through this study, the existing methods of telephone triage in veterinary practices have been investigated, revealing variations in the advice provided by staff. The introduction of new supportive resources has shown an improved decision-making process, giving staff more confidence in recognizing critical cases and providing adequate advice. However, the study was based on a limited sample population, which might affect the generalizability of the findings.

Cite This Article

APA
Lightfoot KL, Burford JH, England GCW, Bowen IM, Freeman SL. (2020). Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study. PLoS One, 15(9), e0238874. https://doi.org/10.1371/journal.pone.0238874

Publication

PloS one
ISSN: 1932-6203
NlmUniqueID: 101285081
Country: United States
Language: English
Volume: 15
Issue: 9
Pages: e0238874
PII: e0238874

Researcher Affiliations

Lightfoot, Katie L
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom.
Burford, John H
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom.
England, Gary C W
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom.
Bowen, I Mark
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom.
Freeman, Sarah L
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom.

MeSH Terms

  • Abdominal Pain / etiology
  • Animals
  • Clinical Decision-Making
  • Health Knowledge, Attitudes, Practice
  • Health Services Research / methods
  • Horse Diseases / diagnosis
  • Horses
  • Hospitals, Animal
  • Surveys and Questionnaires
  • Telephone
  • Triage
  • United Kingdom

Conflict of Interest Statement

The authors have declared that no competing interests exist.

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