Abstract
Few studies have described after-hours calls in hospice patient care. This retrospective study examines the timing of after-hours telephone triage services, the reasons for access to after-hours hospice and palliative care services, and the predominant nursing interventions offered in after-hours calls in hospice and palliative care. A fixed coding scheme was used to code a deidentified after-hours triage phone log of all calls between July 2005 and June 2006 (n = 4434) from a Pennsylvania hospice and palliative care services organization. Descriptive statistics were used to identify call timing pattern, call reasons, and predominant nursing interventions. Triage services were utilized most frequently to request assistance with signs and symptoms control (25.7%), to report death (17.8%), and to request a home visit (15.3%). The top nursing interventions included updating case managers or supervisors about the needs of follow-up (29.5%), coordinating home visits (20.5%), and instructing caregivers or patients on how to control new signs and symptoms (19.8%). A better understanding of when and why patients and their family caregivers utilize after-hours hospice triage services can assist in the design of future proactive interventions to improve care, and enhance training for new and existing hospice triage nurses.