Patient Symptoms & Outcomes

This article discusses a study on the dispositions given to patients by triage nurses in a medical call center. It focuses on the differences in treatment advice between adults and infants, and the reasons for high ER referral rates for adult patients.

The cover of TriageLogic's ebook, Patient Symptoms & Outcomes.

The study analyzed data from a nurse triage call center for the months of April, May, and June in 2016. Nurses used guided protocols written by doctors Barton Schmitt and David Thompson to provide standardized and high-quality care to approximately 40,000 callers. The top reasons why patients called were medication questions, fever, vomiting, sore throat and cough, rash or redness of the skin, immunization reactions in children, earache, and constipation.

The study compared the triage advice given to adult callers with advice given to patients who were a year old or younger. Surprisingly, adults had a significantly higher rate of ER referral and a much lower incidence of home care advice than the overall population. Adults were sent to the ER for pain symptoms — primarily in the chest, abdomen, and back — as well as breathing difficulty and postoperative complications.Older adults were the least likely (only 29%) to be sent to the ER, while younger adult groups had higher rates for this type of referral.

The results indicate that patients are less objective about their own symptoms than those exhibited by their loved ones. Adults tend to be in denial about their own health complications and only call doctors or triage nurses as a last resort. In contrast, parents tend to be more proactive about calling right away if their children experience unusual symptoms. Our study highlights the importance of considering all patient risk factors — including age, chronic illness, recent surgery, medication, and lifestyle — when determining if the emergency room is the most appropriate place for them to go. Each patient should be viewed as an individual, and early warning signs of serious symptoms should be addressed promptly.

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