Enhancing Quality and Safety in Nurse Triage: Introducing Automated QA For Nurse Calls

Thanks to the expansion of telehealth, patient interactions are being conducted increasingly via phone, video chat, and texting solutions. At the forefront of this technology shift are triage nurses, whose roles are indispensable for evaluating patient symptoms and asking questions to determine the right levels of care. But with increasing staff shortages, how do doctors and medical call centers adequately measure nurse triage quality assurance? In this article, we discuss a new tool to automate nurse triage quality, increase nurse performance, and ensure all triage calls are answered appropriately.

Schmitt-Thompson Nurse Triage Protocols

For the past three decades, Schmitt-Thompson protocols have been the gold standard for nurses to use during telephone triage for addressing the needs of their patient callers. These protocols serve as a framework for nurses to make critical decisions about which providers their patients should see, and how soon they should see them. This eliminates the guesswork that most patients often experience when it comes to their symptoms, avoids unnecessary visits that may overwhelm medical centers, primary care physicians, or emergency departments, and improves health outcomes for those patients who do need more immediate medical attention. (In fact, the aim of this study on nurse triage during the first year of the COVID-19 pandemic found a strong correlation between those healthcare providers that used nurse triage and the overall improvement of patient health, as well as higher revenue.)

Beyond training triage nurses on how to interact with patients, utilize their listening skills, and follow a 10-step triage process, Schmitt-Thompson protocols have been the primary tool in the industry for ensuring that nurses guide patient callers to the appropriate care. 

Integrating these protocols with nurse triage software, and allowing that software to share triage documentation directly with providers, was the logical solution for improving patient safety and continuity of care — especially for high-risk symptoms like chest pain and difficulty breathing that require immediate attention. Now those protocols are being applied to automation.

TriageLogic’s QA Assist Solution

Nurse triage quality assurance depends on verifying that nurses are making the right decisions over the phone, yet the call volume that organizations can review tends to hover around one to three percent. This recording review is usually manual, where employees are tasked with listening to each triage call and comparing nurse guidance against the health outcome of the patient. At most, this could mean only reviewing three or four phone calls per nurse. While this may offer some oversight into a nurse’s triage experience and protocol accuracy, such a small sample size still severely limits medical QA and offers a less-than-ideal representation of overall quality.

For that reason, TriageLogic has developed the software solution known as QA Assist. Our patent-pending system can automate the review of roughly 70 – 85 percent of phone calls in real time. It looks at the predicted outcome of each call against what the nurse actually assigns so that a manager can quickly review a decision that may or may not have been appropriate — all without any additional burdens on your nurses or your QA staff. 

Benefits of QA Assist

Besides the obvious improvement for the total number of calls that can be reviewed, QA Assist offers several key benefits to medical providers.

Liability. Nurse triage software and protocols already help providers reduce their liability by offering a digital paper trail of all patient interactions and nurse dispositions. QA Assist adds to that protection by showing what dispositions make sense based on the protocols that nurses select, compared with the guidance they actually give. In those instances where dispositions don’t align with nurse guidance, managers can consult with those nurses to understand why protocols may have been overridden.

Reporting. QA Assist produces comprehensive reports that simplify the task of evaluating how often nurses: 1) offer patients the appropriate dispositions for care; 2) refer patients to physicians without sufficient need; and 3) do not refer patients to physicians when the need is there. This data can be benchmarked against overall QA and individual nurse performance to identify top performers versus those who may require additional education.

Integration. QA Assist can be seamlessly integrated with existing healthcare systems like EPIC. It also comes with robust cybersecurity, and meets all standards for HIPAA compliance. 

Training. This system is easy to learn and implement because it offers self-guiding instruction.

Ultimately, this triage solution delivers unprecedented patient safety and facilitates targeted training for nurses in their respective roles. It provides healthcare organizations with a more effective tool for enhanced quality assurance, allowing a higher standard of care for your patients.

Would You Like to See a Demo?

Please contact us if you’re interested in learning more about QA Assist and how it can benefit your nurse triage quality assurance. We’re excited to offer this as the first automated solution in a suite of quality improvement tools planned for release during the second half of 2023.