Time requirements for management of exposure and information cases by one regional poison center

摘要

Background: Poison control centers (PCCs) manage millions of information and exposure cases a year. Exposure cases are almost always managed on-site (i.e., at "home") or at a health care facility (HCF). Over the last 10 years, there have been significant changes in the composition of cases managed by PCCs with an overall decrease in total cases but an increase in exposures managed at an HCF. The management and documentation of HCF cases may require more time than cases managed on-site or information cases. Time-work data are needed to accurately gauge the staff resources needed to address these changes. Methods: One poison center with an annual case volume of 74,000 conducted a time-work study of total case management time for a subset of cases: exposures Managed on-site and Managed at an HCF as well as information Drug identification cases. Specialists tracked the time spent communicating, managing, researching, consulting, and documenting. Additionally, the PCC medical records and phone call database were audited to ensure all calls and documented efforts related to a case were included. Results: Cases Managed at an HCF (n = 140) took more time (mean 45.8 min, median 29.3 min) than those Managed on-site (n = 430; mean 7.4 min, median 5.9 min) or Drug identification case (n = 392; mean 2.7 min, median 2.2 min); this difference was significant (p<.0001). There were 32 cases (23%) Managed at an HCF that required more than 1 h for total management; no Managed On-site or Drug identification cases required more than 33 min. Conclusions: The time required for one PCC to manage cases at an HCF was approximately six times longer than cases that were managed on-site. With PCC case volume and composition changing, previous staffing assumptions may no longer hold true. It would be incorrect to base staffing requirements on case volume alone without scrutiny of case types.