Educating Swedish telenurses to improve caller experience: Reflections on a pilot study

Abstract

Telenurses employed at Swedish Healthcare Direct offer triage recommendations and self-care advice to the general public over the telephone on a wide range of health problems. Their understanding of work and ability to communicate are essential for callers’ adherence to recommendations and satisfaction with the service. This paper presents and reflects upon an educational intervention for Swedish telenurses which aimed to improve caller experience. Twelve telenurses participated. Six were randomised to an intervention group, the other six to a reference group. The nurses in the intervention group individually listened to, and reflected on their authentic calls together with one of the researchers on five to six separate occasions. Callers’ experiences were surveyed using a postal questionnaire sent within 48 hours of their call, both before and after the intervention. Descriptive and comparative statistics as well as content analysis were used in the analysis of the questionnaires. The most striking finding was that the educational intervention did not seem to have any effect on outcomes of the telenurses calls. Other findings revealed that a large group of callers, about 20%, did not find the call useful and only 50% to 60% of the callers reported that they had learned something from the call. Callers’ most frequent unfulfilled expectations centred on not being referred to a physician, and a perceived low level of competence among telenurses. The modest impact of the intervention on the services of telenursing may have been due to the participating nurses, the organisation, or the design of the intervention. Lessons have been learned that need to be taken into account in future and more large scale studies.