I really hate our new phone hold message . . . and so do those who use our services . . . but we had to make the change to reflect our new reality.
For the past three years, the IPC has been the classic story of a struggling non-profit public health service faced with an increasing need for services while coming to grips with rapidly declining support from funding agencies. In response to the loss of funding, the Illinois Poison Center has had to make difficult staffing changes to bring expenses in line with the new lower revenues. The need for poison center services however, has increased tremendously in this same period of time, leading to a difficulty in meeting the needs of the Illinoisans we serve.
In 2011, the CDC called poisoning an epidemic:
- There are more deaths each year from poisoning than gunshot wounds
- There are more poisoning deaths than deaths from motor vehicle accidents
Poison centers however deal with the living, not those individuals who have died outside of the hospital setting which is how most of these statistics are gathered.
- In Illinois, there are more hospital admissions for poisoning related injury than there are for the major trauma categories of gunshot wounds and motor vehicle accidents combined.
And hospital consultation is the area that the demand for our services has grown tremendously in the past 8 years. In 2003, the IPC provided treatment advice to 12,468 doctors, nurses, pharmacists and EMS professionals seeking assistance with poisoned patients in their care. In 2011, the IPC helped 19,566 healthcare providers seeking treatment recommendations. This is a 57% increase in the need of our services, for the most critically ill patients scattered throughout Illinois.
Since 2009 however, IPC funding was reduced by 31% by the state of Illinois and 36% by the federal government. We now receive less money from these two sources than we did in 2003. The equation is simple, less funding means less staff. Less staff to handle an increasing need for service means a longer hold time on our emergency hotline service.
In 2008, our average time to answer a call was about 8 seconds. By the end of 2011, it had increased to 27 seconds. This is an eternity to a mother, father, nurse or doctor. The National Emergency Number Association (911) has a guideline that 90% of calls should be answered in the first 10 seconds and 95% of calls in the first 20 seconds. While previously very close to 911 standards, our staffing reductions have left us with less than perfect ‘time to answer’ performance.
Because of long wait times, our hang up rate has gone from about 1.5% to 3.7% of calls. By not providing timely information, people are opting to hang up and go to the ER (perhaps unnecessarily) or looking for information elsewhere that may not be delivered by specially trained poison experts; all potentially leading to wasteful use of resources or bad clinical outcomes. The lack of sufficient funding has affected the IPC to the point where the delay in service is now a public and patient safety issue.
Over the next 8 months, we will be reaching out to those who use our services, educational partners and other organizations for support to maintain and eventually restore some of the lost funding at both the State and Federal level. Ultimately, we would all prefer that callers do not hear our hold message; your call is important to us, and we would rather provide immediate help instead of having people wait in a virtual waiting room.
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- IPC: Providing Toxicology Consults in Illinois