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Development and testing of the KERNset: an instrument to assess the quality of telephone triage in out-of-hours primary care services

Overview of attention for article published in BMC Health Services Research, December 2017
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1 tweeter

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12 Dimensions

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Title
Development and testing of the KERNset: an instrument to assess the quality of telephone triage in out-of-hours primary care services
Published in
BMC Health Services Research, December 2017
DOI 10.1186/s12913-017-2686-1
Pubmed ID
Authors

Marleen Smits, Ellen Keizer, Paul Ram, Paul Giesen

Abstract

Telephone triage is a core but vulnerable part of the care process at out-of-hours general practitioner (GP) cooperatives. In the Netherlands, different instruments have been used for assessing the quality of telephone triage. These instruments focussed mainly on communicational aspects, and less on the medical quality of triage decisions. Our aim was to develop and test a minimum set of items to assess the quality of telephone triage. A national survey among all GP cooperatives in the Netherlands was performed to examine the most important aspects of telephone triage. Next, corresponding items from existing instruments were searched on these topics. Subsequently, an expert panel judged these items on importance, completeness and formulation. The concept KERNset consisted of 24 items about the telephone conversation: 13 medical, ten communicational and one regarding both types. It was pilot tested on measurement characteristics, reliability, validity and variation between triagists. In this pilot study, 114 anonymous calls from four GP cooperatives spread across the Netherlands were judged by three out of eight raters, both internal and external raters. Cronbach's alpha was .94 for the medical items and .75 for the communicational items. Inter-rater reliability: complete agreement between the external raters was 45% and reasonable agreement 73% (difference of maximally one point on the five-point scale). Intra-rater reliability: complete agreement within raters was 55% and reasonable agreement 84%. There were hardly any differences between internal and external raters, but there were differences in strictness between individual raters. The construct validity was confirmed by the high correlation between the general impression of the call and the items of the KERNset. Of the differences within items 19% could be explained by differences between triage nurses, which means the KERNset is able to demonstrate differences between triage nurses. The KERNset can be used to assess the quality of telephone triage. The validity is good and differences between calls and between triage nurses can be measured. A more intensive training for raters could improve the reliability.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 31 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 19%
Student > Ph. D. Student 5 16%
Student > Doctoral Student 3 10%
Lecturer 3 10%
Researcher 3 10%
Other 5 16%
Unknown 6 19%
Readers by discipline Count As %
Nursing and Health Professions 9 29%
Medicine and Dentistry 7 23%
Social Sciences 2 6%
Veterinary Science and Veterinary Medicine 1 3%
Business, Management and Accounting 1 3%
Other 2 6%
Unknown 9 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 December 2017.
All research outputs
#7,665,299
of 12,265,937 outputs
Outputs from BMC Health Services Research
#2,823
of 4,016 outputs
Outputs of similar age
#191,161
of 343,676 outputs
Outputs of similar age from BMC Health Services Research
#128
of 212 outputs
Altmetric has tracked 12,265,937 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,016 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.3. This one is in the 19th percentile – i.e., 19% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 343,676 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 34th percentile – i.e., 34% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 212 others from the same source and published within six weeks on either side of this one. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.