The 5 levels of Telephone Nurse Triage
Stressed Asian Senior woman talking and consulting with Female Doctor about her symptoms from Coronavirus via internet and wireless technology. Rear view of old female making video call from home with physician via digital tablet during quarantine.

The 5 levels of Telephone Nurse Triage

When a telephone triage nurse evaluates a patient, she has to properly evaluate the severity of the symptoms presented to determine the correct disposition. TriageLogic nurses use Schmitt-Thompson protocols to guide them into asking the right questions, properly document information, and give patients an accurate disposition for the most appropriate level of care.  There are 5 levels of telephone triage dispositions: Call 911, go to an urgent care facility, be seen by a doctor the next morning, go see a doctor within 3 days, or get home care advice. 

There are significant benefits to asking the right questions.  With these questions, nurses are able to standardize care approaches, reduce errors and liabilities, and create a more-efficient process for assessing patients. The Schmitt-Thompson protocols cover more than 90% of medical calls. The protocols are symptom-based (cough, fever), exposure-based (influenza), and disease-based interactions. Once the appropriate questions are asked, patients can be slotted into one the five disposition levels.

There are five main disposition categories that patients can be assigned to by telephone nurses:

911 – The nurse instructs the patient to hang up and call 911 immediately.

Urgent – Patients are told to go to an Emergency Department or contact their physician immediately.

See Doctor in 24 to 48 hours  – Patients are generally told to call their Primary Care Physician when the office is open and see the PCP within 24 – 48 hours.

Homecare – Nurses advise patients on homecare. Nurses might encourage patients to call their PCP or see the PCP within two weeks.

Other –Includes calls where nurses instructed patients to call local agencies, ordered lab tests, etc. (generally less than 1% of all calls).

The figure below presents the assigned disposition results for all adult patients who called between January and October of 2020. We find that about 29% of adult callers had serious medical symptoms that required urgent attention. About 1% of callers were told to call 911.

Figure 1: Dispositions advice assigned to adult callers by the triage nurse.

By following protocol and asking the right questions, TriageLogic telephone nurses were able to assist patients with severe symptoms. Telephone triage saves lives. Our ultimate goal is to extend access to healthcare to as many people as possible, and we have made Covid protocols, available to doctors and nurses for free. Click here to create an account, and you will have access to the full spectrum of Covid telephone nurse triage care. The Schmitt-Thompson disposition protocols aid our nurses in providing quality care to patients. We also offer free courses for nurses in our Learning Center.

Contact us today to discuss your needs and we will set up a customized plan that works best for your organization and your patients.

Learning Center: courses and videos, learn more about telephone triage