Advertisement

Out-of-hours calls in clinical microbiology: the when, the why and from whom

  • Hilary HumphreysEmail author
Original Article
  • 25 Downloads

Abstract

Microbiology services provided to hospitals must be delivered 24 h a day. In addition to during routine so-called ‘office hours’, clinical microbiologists have to provide an on-call service 7 days a week. However, there are few data on what that involves and how the service is delivered. I reviewed the source, reason for, grade of staff from whom the call came and the need for any follow-up, over an 11-year period using a pro-forma, that had been used to review data before this time period. Details were available for 90% of calls received, and data from 809 calls were analysed. The sources of calls were most commonly from medicine specialties [163/809 (20.1%)], neurosurgery (which is a national referral centre) [148/809 (18.3%)] and the intensive care unit [143/809 (17.7%)]. The number of calls received between 23.00 hours and 07.00 hours was 107 (13.2%). Just over half of calls, i.e. 440/809 (54.6%), were related to treatment; 247/809 (30.5%) were for advice on diagnosis; and 79/809 (9.8%) were related to infection prevention and control (IPC) issues. Registrars (a senior training grade) accounted for 492/809 (60.8%) of calls, and 64/809 (7.9%) came from nurses mainly related to IPC matters. Overall, 25.4% (206/809) of calls required follow-up the next day but this increased from 4.5% in 2013 to 67.6% in 2018. The nature of calls received by a clinical microbiologist out-of-hours is varied and may be increasing due to the complexity of case mix and changes in medical staffing. Professional and other organisations would do well to review such workload when deciding on staffing levels and service planning, given increasing public and patient expectations, and the trend towards the centralisation/consolidation of laboratory diagnostic services.

Keywords

Out-of-hours On-call Clinical microbiology Treatment Diagnosis Infection prevention and control 

Notes

Acknowledgements

I am grateful to my clinical microbiology colleagues for their support and encouragement over many years, including Edmond G. Smyth and Fidelma Fitzpatrick who also kindly reviewed the manuscript. I also want to acknowledge our medical laboratory scientists for their unfailing professionalism, expertise, commitment, support and advice. Finally, I want to thank my family for their patience, especially when late night calls also interrupted their sleep.

Author contribution

I am the sole author and hence I collected, collated and analysed the data. I also both drafted and finalised the manuscript.

Funding information

The data reported here, its collation and the drafting of the manuscript were not externally funded but were carried out as part of routine work.

Compliance with ethical standards

Ethical issues

As this was part of routine service delivery, and as the data collected relates to my own professional practice, and since the manuscript does not contain any directly or indirectly identifiable patients, no submission to an ethics committee was considered necessary.

References

  1. 1.
    Humphreys H, Nagy E, Kahlmeter G, Ruijs GJHM (2010) The need for European professional standards and challenges facing clinical microbiology. Eur J Clin Microbiol Infect Dis 29:617–621CrossRefGoogle Scholar
  2. 2.
    Humphreys H (2009) Where do out-of-hours calls to a consultant microbiologist come from? J Clin Pathol 62:746–748CrossRefGoogle Scholar
  3. 3.
    Riordan T, Cartwight K, Logan M, Cunningham R, Patrick S, Coleman T (2002) How do microbiology consultants undertake their jobs? A survey of consultant time and tasks in South West England. J Clin Path 55:735–740CrossRefGoogle Scholar
  4. 4.
    Cartwright K, Lewis D, Roberts C, Bint A, Nichols T, Warburton F (2002) Workload and stress in consultant medical microbiologists and virologists: a questionnaire survey. J Clin Path 55:200–205CrossRefGoogle Scholar
  5. 5.
    Mehtar S (1995) Review of a consultant microbiologist’s work practice—an audit. J Clin Pathol 48:1082–1086CrossRefGoogle Scholar
  6. 6.
    Balfour A (1996) Review of clinical activity by microbiologists. J Clin Pathol 49:429–431CrossRefGoogle Scholar
  7. 7.
    Chadwick PP, Barnes A, Oppenheim BA (1996) Review of clinical activity by microbiologists. J Clin Pathol 49:780CrossRefGoogle Scholar
  8. 8.
    Wooster SL, Sandoe JAT, Struthers JK, Loudon KW, Howard MR (1999) Review of the clinical activity of medical microbiologists in a teaching hospital. J Clin Pathol 52:773–775CrossRefGoogle Scholar
  9. 9.
    Scheetz MH, Postelnick MJ, Scarsi KK et al (2005) Effect of on-call infectious diseases pharmacists on antibiotic expenditures. Am J Health-Syst-Pharm 62:1967–1968CrossRefGoogle Scholar
  10. 10.
    The Royal College of Pathologists (2001). Consultant workload and staffing in medical microbiology and virology. Report of a working group of the Royal College of Pathologists.Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of MicrobiologyBeaumont HospitalDublinIreland
  2. 2.Department of Clinical Microbiology, RCSI Education and Research Centre, Beaumont HospitalThe Royal College of Surgeons in IrelandDublinIreland

Personalised recommendations