Ambulatory oncology nursing telephone services: A provincial survey

A survey of telephone nursing provided through ambulatory oncology programs in Ontario was conducted May to July 2006. Of 38 programs, 58% used primary nurses, 24% used a centralized triage approach, and 18% used a mixed model. About half of programs used protocols (61%), routinely documented calls (55%), and/or provided orientation to telephone nursing (45%). Few programs (29%) monitored telephone service quality. Practice strengths included: improved patient access, early symptom management, and increased continuity of care. Revealed barriers to using protocols were limited access to or awareness of protocols, management of multiple symptoms, inconsistencies with physician practices, concern that protocols replace critical thinking, inadequate time, and lack of electronic protocols. Participants acknowledged the need for electronic documentation, standardized criteria to monitor service quality, and further research to benchmark best practices.