- Email: [email protected]
Increased efficiency: reduced costs. Impact of changing access to TIS telephone counseling services
586
Reproductive Toxicology
Purpose: The purpose of our study was to determine the incidence of breastfeeding initiation among women on chronic antithyroid therapy, specifically propylthiouracil (PTU), and to determine the factors influencing their decisions to choose a particular feeding method. Methods: After consultation at the Motherisk Clinic, many patients are followed up to ascertain the outcome of pregnancy. Along with pregnancy outcome, various questions regarding feeding methods are also asked. Three groups of women were compared: those who took PTU postpartum, those with a recent history of hyperthyroidism who no longer required PTU therapy, and a group of healthy controls. Results: A total of 22 women took PTU postpartum while 16 were in the non-PTU group and 22 were the healthy controls. Six (27%) of the PTU patients decided to initiate breastfeeding after delivery while 13 (81%) of the non-PTU group and 20 (91%) of the controls breastfed (P = 0.0001). Of those patients who did breastfeed, the average duration in the PTU group was 3 2 2 months, 4 + 3 months in the non-PTU group, and 7 t 4 months in the healthy controls (P = 0.014). The most frequently cited reason for not breastfeeding in the PTU group was a concern about exposure of the child to medications through the milk, while in all groups those who chose to breastfeed felt that breast milk was a superior form of nutrition for the child. Conclusions: Mothers taking PTU are less likely to initiate breastfeeding after the birth of their child because of their concerns about taking medication. Given the benefits of breastfeeding for both mother and the child, it is imperative that mothers taking chronic medication such as PTU are encouraged to breastfeed their children and that health care professionals are informing their patients that the medication is not likely to harm their children.
Increased efficiency: reduced costs. Impact of changing access to TIS telephone counseling services.
Motherisk Program, Hospital for Sick Children, Toronto, Canada. Previous System: Counselors serviced three incoming telephone lines. When these lines were busy, callers would be asked to leave a voicemail message; up to 150/d were left. A fourth counselor would spend much of the day retrieving and recording these messages, contacting these callers, playing “telephone tag,” and only completing a modest number of calls. This was an inefficient use of the counselor’s time, and very frustrating to the callers who often
Volume 9, Number 6, lYY5
perceived that they were not being contacted by Motherisk quickly enough. The program incurred large costs returning long distance telephone calls, which comprised 25% of the daily calls. With this system, telephone costs were approximately $15001 month. There were an average of 50 to 70 received telephone calls each day (i.e., March 1995). New System: This system now gives callers the opportunity to wait in line for the next available counselor or to leave a voicemail message. Now the average number of messages left on voicemail is IO/d. Telephone costs are now approximately $360/ month (i.e., April 1995). There are now three counselors instead of the four previously needed, and the number of calls average 80 to 100/d. The fourth counselor is now able to perform other duties such as research, literature searches, and compiling new information. Caller satisfaction has increased. When randomly asked, most callers felt it was worth the wait-sometimes up to one-half hour-to speak with a counselor the same day, rather than having to leave a message on the voicemail. Conclusion: The changes in the telephone system have had a positive effect on both the counselors and callers. The callers, who are often extremely anxious and upset, are thankful to know that their questions will be answered right away. The counselors feel less frustrated and can now actually spend time completing calls. For the Program, telephone costs are reduced while more calls are being completed. The bottom line: costs are down, efficiency and satisfaction are up, a win-win situation.
Teratogen information service risk communication: home environmental paint exposure during preg-
nancy. M Kerr, J Dobbins, K Linn, .I Russo, K Filkins. The Pregnancy Safety Hotline, Department of Reproductive Genetics and Obstetrics and Gynecology, Western Pennsylvania Hospital, Pittsburgh, PA. Our Teratogen Information Service (TIS), the Pregnancy Safety Hotline, fields a variety of patient/ health professional inquiries on medications, illicit drugs, infections, occupational, and environmental exposures. The public is becoming more concerned about potential reproductive hazards in the workplace and community. Our TIS statistics show that environmental inquiries constitute roughly 25% of the total calls received. Right-to-Know legislation has continued to heighten awareness of exposures both in the workplace and home. Although many
Reproductive Toxicology
Purpose: The purpose of our study was to determine the incidence of breastfeeding initiation among women on chronic antithyroid therapy, specifically propylthiouracil (PTU), and to determine the factors influencing their decisions to choose a particular feeding method. Methods: After consultation at the Motherisk Clinic, many patients are followed up to ascertain the outcome of pregnancy. Along with pregnancy outcome, various questions regarding feeding methods are also asked. Three groups of women were compared: those who took PTU postpartum, those with a recent history of hyperthyroidism who no longer required PTU therapy, and a group of healthy controls. Results: A total of 22 women took PTU postpartum while 16 were in the non-PTU group and 22 were the healthy controls. Six (27%) of the PTU patients decided to initiate breastfeeding after delivery while 13 (81%) of the non-PTU group and 20 (91%) of the controls breastfed (P = 0.0001). Of those patients who did breastfeed, the average duration in the PTU group was 3 2 2 months, 4 + 3 months in the non-PTU group, and 7 t 4 months in the healthy controls (P = 0.014). The most frequently cited reason for not breastfeeding in the PTU group was a concern about exposure of the child to medications through the milk, while in all groups those who chose to breastfeed felt that breast milk was a superior form of nutrition for the child. Conclusions: Mothers taking PTU are less likely to initiate breastfeeding after the birth of their child because of their concerns about taking medication. Given the benefits of breastfeeding for both mother and the child, it is imperative that mothers taking chronic medication such as PTU are encouraged to breastfeed their children and that health care professionals are informing their patients that the medication is not likely to harm their children.
Increased efficiency: reduced costs. Impact of changing access to TIS telephone counseling services.
Motherisk Program, Hospital for Sick Children, Toronto, Canada. Previous System: Counselors serviced three incoming telephone lines. When these lines were busy, callers would be asked to leave a voicemail message; up to 150/d were left. A fourth counselor would spend much of the day retrieving and recording these messages, contacting these callers, playing “telephone tag,” and only completing a modest number of calls. This was an inefficient use of the counselor’s time, and very frustrating to the callers who often
Volume 9, Number 6, lYY5
perceived that they were not being contacted by Motherisk quickly enough. The program incurred large costs returning long distance telephone calls, which comprised 25% of the daily calls. With this system, telephone costs were approximately $15001 month. There were an average of 50 to 70 received telephone calls each day (i.e., March 1995). New System: This system now gives callers the opportunity to wait in line for the next available counselor or to leave a voicemail message. Now the average number of messages left on voicemail is IO/d. Telephone costs are now approximately $360/ month (i.e., April 1995). There are now three counselors instead of the four previously needed, and the number of calls average 80 to 100/d. The fourth counselor is now able to perform other duties such as research, literature searches, and compiling new information. Caller satisfaction has increased. When randomly asked, most callers felt it was worth the wait-sometimes up to one-half hour-to speak with a counselor the same day, rather than having to leave a message on the voicemail. Conclusion: The changes in the telephone system have had a positive effect on both the counselors and callers. The callers, who are often extremely anxious and upset, are thankful to know that their questions will be answered right away. The counselors feel less frustrated and can now actually spend time completing calls. For the Program, telephone costs are reduced while more calls are being completed. The bottom line: costs are down, efficiency and satisfaction are up, a win-win situation.
Teratogen information service risk communication: home environmental paint exposure during preg-
nancy. M Kerr, J Dobbins, K Linn, .I Russo, K Filkins. The Pregnancy Safety Hotline, Department of Reproductive Genetics and Obstetrics and Gynecology, Western Pennsylvania Hospital, Pittsburgh, PA. Our Teratogen Information Service (TIS), the Pregnancy Safety Hotline, fields a variety of patient/ health professional inquiries on medications, illicit drugs, infections, occupational, and environmental exposures. The public is becoming more concerned about potential reproductive hazards in the workplace and community. Our TIS statistics show that environmental inquiries constitute roughly 25% of the total calls received. Right-to-Know legislation has continued to heighten awareness of exposures both in the workplace and home. Although many