Inpatient hospice triage of 'after-hours' calls to a community palliative care service.
This article reports on a retrospective study of the provision of 'after-hours' telephone support by a community palliative care service during 1996 and 1997. Calls received outside of normal office hours were triaged through an inpatient hospice unit located in the same building as the community team. During the study period, 629 patient or carer calls were received, predominantly between 5pm and 11 pm. The main reasons cited for using the after-hours service were medication queries, pain, seeking advice from the nurse and anxiety. The triage nurse successfully handled 30% of the calls. The remaining 70% of calls were transferred to the on-call community palliative care nurse, resulting in 251 home visits. Visits were not predicted by call reason, patient living arrangements, diagnosis or clinical problems; the patient being close to death or having died was a predominant reason for visiting. It was found, however, that call outcomes could be partly predicted by the identity of the triage nurse. It is argued that the findings of this study raise important issues related to the provision of after-hours palliative care and the training of staff providing triage of calls from patients and families at home.