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The Evolving Requirements of Telephone Triage Software and Training
by Charu G. Raheja, PhD
Over the last seven years, new communication resources have dramatically shifted the way telephone medicine is conducted. No longer are nurses and managers required to drive to hospital or call-center basements and monitor fax machines, distribute calls, and be available in person to help each other and answer questions. Call centers no longer have to depend on the nurses that are present and assigned to take the calls, and no longer must they delay calling patients back when the call volume surges unexpectedly.
The development of better software and communication systems has allowed telephone triage nurses and managers to work remotely. This model offers several advantages, including allowing call centers to manage call volume better by immediately calling on additional nurses if they have a sudden surge of phone calls and need backup help. Nurses can also work from home, saving themselves the time and expense of commuting, and they can choose shorter shifts because it is easier for other nurses to take over.
While there are several advantages of having more flexibility and allowing nurses to work from home, this new model also poses some challenges. For example: How will a manager monitor and maintain quality with the nurses working remotely? Can a manager help nurses when he or she is dealing with a difficult case and they’re both working remotely? How do call centers continue emphasizing the seriousness of the job and the importance of following HIPAA regulations even though nurses are working from home?
In order to address these new issues that come with remote work, there is a need for a new software design and new training and guidelines for the triage nurses.
Software requirements for the new model
First, the new telephone triage software must compensate and allow triage nurses to work together in distributing and taking phone calls without being present in the same location. This means that the software must have an entry point that a manager and the on-call nurses are able to see at the same time and manage from their different locations. Managers need to be able to distribute calls to various nurses and at the same time be able to remotely oversee the calls that the nurses are currently handling. Following are some key features that call center software needs for effective remote work:
1. Easy access from multiple entries – The software needs to be accessible from multiple computers. Although care must be taken ensure that the software is secure from outside hackers, a web-based system is ideal since it allows nurses to access the software from any computer or iPad.
2. Thorough documentation – Because the staff is working remotely, it’s even more to crucial to document as much as possible, to be able to review cases if there are any issues or questions. Ideally, the system should have quick and simple ways to document, such as drop-down lists and checkboxes that allow nurses to record all the information but at the same time remain efficient while taking calls. It is also important that each staff member be logged in with a time stamp and user ID, so that it is possible to go back and verify all the changes that each user made to the system.
3. Remote monitoring of call volume and workflow –Supervisors need to be able to monitor and assign calls remotely. The system needs to allow managers to do their work without being in the call center, including, for example, remote access to calls in the queue, prioritizing by chief complaint, and sorting calls based on nurse specialty.
4. Reports – More and more often, our society is using data to learn about consumer behavior and wants. Medicine is no different. Having good reports of the phone calls is crucial to help the call center ensure effective patient care. Reports should provide data such as call volumes at different points in time, the protocols used by the nurse, demographic data on the patient callers, etc.
5. Easy-to-use and intuitive system – the job of a triage nurse is to take care of patients by determining the seriousness of their condition over the phone. Thus, while the system needs to be able to coordinate with all the nurses and staff working remotely, it also needs to be easy enough so that nurses can troubleshoot and use the system without requiring a lot of help.
Finally, it is important to keep in mind that the continuously evolving nature of communication and technology products and systems make it important that the software be flexible enough to adapt to new technology and allow integration with other electronic health records and systems.
Nurse education and training for remote work
Telephone triage nurses are regularly faced with difficult call situations. Callers are often worried, stressed, and unsure what to do. To efficiently triage a patient, nurses need to be free of distractions, allowing them to focus on assessing the caller’s symptoms. This need for a lack of distraction is when working remotely can be a problem.
When training nurses who will be working remotely, it is important to make it clear that they are expected to be working in a separate room, away from distractions and fully engaged in the calls. Nurses also need to understand that they are bound by the same HIPAA rules as in an office or a hospital call center, and the remote call center needs to have specific training and education on how to remain HIPAA compliant while working from home. According to one of our Nurse Triage call center managers, Marci Lawing, RN “Many nurses do not realize going into remote work that telephone triage is just as risky as working in a hospital setting.”
Working remotely has positives and negatives for the nurses. On the positive side, the autonomy that comes from working remotely can be very appealing. While a defined workspace is a must, most nurses enjoy the luxury of working from home. Depending on the call center policy, the nurses may also have the freedom of choosing their own schedule and they may be able to choose to work shorter shifts, which can make it easier for them both mentally and physically.
On the negative side, since the nurses work remotely, they do not see their coworkers in person, which can lead to loneliness and isolation. This isolation makes it crucial that nurses communicate with each other regularly. That means either making phone calls to each other, or communicating through email, text messaging or a web meeting. Managers themselves also need to find ways to effectively communicate with the nurses remotely. The continuing development of new technology has made it easier to communicate remotely, and software that allows nurses to see each other’s faces while communicating can significantly help improve their connection with one another.
Healthcare is a part of our rapidly evolving communication world, and new resources allow us to work more efficiently and in a better work environment. It is important to develop new telephone triage software, solutions and training that will allow us to take advantage of the new resources. Feel free to contact me by email or by commenting on my article if you have any questions about remote nursing in telephone triage.
About the author:
Charu G. Raheja, PhD is the CEO and Chair TriageLogic
Founded in 2005, TriageLogic is a URAC accredited, leading provider of quality triage solutions, serving over 3,000 physicians and covering 6.5 million lives. TriageLogic provides both software and after-hours nurse triage services. Whether you need nurse triage software for your call center or your office, an outsourced nurse triage service, or a combination of the two, TriageLogic has a customized, cost effective product to meet your needs. For more information contact Amy Smith at 888-TEAMTLC or visit www.triagelogic.com.