Can Telephone Nurse Triage Cut Down on Unnecessary ER Visits During COVID-19?

Can Telephone Nurse Triage Cut Down on Unnecessary ER Visits During COVID-19?

In our last article, “Does Telephone Nurse Triage Save Lives during COVID-19?” we used data from TriageLogic’s call centers to show that telephone nurse triage can help save patient lives. Using a set of standardized protocols, triage nurses can identify if a patient’s symptoms are serious and direct them to the appropriate level of care. 

In addition to saving patient lives, nurse triage can save money by reducing the need for unnecessary ER visits, which are costly in terms of resources and money. Each ER visit costs about $2000. Unnecessary ER visits also increase strain on healthcare systems, especially during the COVID-19 pandemic when hospitals are already overburdened. Nurse triage can reduce the number of unnecessary ER visits, benefiting both patients and providers. 

Responses From the Patient Survey: Were You Planning to go to the ER? 

We studied data from about 130,000 calls from our call centers over a period of 8 months from March 2020 through October 2020 during the COVID-19 pandemic. Each data entry contained information about the patient’s demographics, the patient’s disposition, and the triage protocol. In addition to evaluating patients and giving them a disposition for their symptoms, nurses asked patients whether or not they were planning to go to the Emergency Room (ER) prior to calling the nurse. Figure 1 provides a breakdown of the patient response on whether or not they were planning to go to the ER. We find that about 12% of patients were planning on going to the ER prior to the call. 

The following figure provides a full description of the survey results.

 

Outcomes From Patient Phone Calls

Next, we look at the caller dispositions given by the nurses. The patient’s disposition indicates the level of care that patients are assigned to by the triage nurse. The main categories of dispositions are: 911, Urgent, See Doctor in 24 to 72 hours, Other, and Homecare. Urgent refers to patients that needed to go to the ER or seek other urgent care. 

Of the 130,000 calls that we received over this time period, about 21% were classified as “urgent,” meaning that the patient needed to go to an emergency department or contact their physician immediately. For more information on dispositions and patient demographics, please refer to our previous article Data on Nurse Triage During COVID-19.

 

What Percentage of Callers Overestimate the Severity of their Symptoms? 

We then compared survey responses with the patient’s disposition in order to calculate ER visits saved. The survey does not include emergency cases where the patient called the triage nurse instead of calling 911. In emergent cases, patients were told to call 911 immediately. Excluding cases where the nurse instructed the patient to call 911, about 12% of patients, indicated in red in Figure 1, told the nurses that they were thinking about going to the ER. Figure 3 presents the dispositions for patients who were thinking about going to the ER.

 

Of those patients who were planning to go to the ER, about 41% did not need to seek urgent medical attention. 17% of patients who thought they needed to go to the ER were told to see a doctor within 24 to 48 hours. 24% could be treated with homecare. 

The results of this study suggest that telephone nurse triage can save unnecessary ER and doctor’s visits. Two out of every five patients who were thinking about going to the ER did not need urgent medical attention. Nurse triage provides a safe and effective way to direct patients to the appropriate level of care, which is more important than ever during COVID. By reducing unnecessary ER visits, nurse triage saves time and money for both providers and patients. 

Do you want your patients to have access to a triage nurse 24/7? Do you want your nurses to have standardized protocols to follow and document patient calls? Contact us today and find out how we can help.