Pediatric Telephone Triage: There's No Place Like Home

The After Hours Program at The Children's Hospital of Philadelphia provides telephone triage during nights, weekends, and holidays for 27 pediatric practices and two specialty offices. From September 1997 to October 2009, nurses commuted to the After Hours Call Center located in an office building in a densely populated area of the city of Philadelphia. One challenge for management of the center had been staff members' dissatisfaction with the time of their shift, working weekends and holidays, and the necessity to travel and work in an urban setting during non-daytime hours. Staff dissatisfaction translated into suboptimal staffing due to decreased retention. It also became difficult to attract experienced pediatric nurses to work for the program. Beginning in October 2009, the After Hours Program's nursing staff was gradually moved to home-based offices with the transition to home completed by the end of November 2009.