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Objective. This project explored the communication processes associated with poison control center calls. Methods. In this preliminary study, we adapted the Roter Interaction Analysis System to capture staff-caller dialogue. This involved case selection, wherein adherence and non-adherence cases were selected; call linkage to medical records, where case records were linked with voice recordings; and application of Roter Interaction Analysis System to calls. Results. Results indicate that communications are predominantly provider- driven, Patient age and percentage of staff partnership statements were significantly associated with adherence at the 0.05 level. Increases in age were associated with decreases in adherence to recommendations (p < 0.001). Increases in percentage of staff partnership statements (over all staff talk) were associated with increases in adherence (p = 0.013). Conclusion. This line of research could lead to evidence- based guidelines for effective staff-caller communication, increased adherence rates, and improved health outcomes.