Triage nurses can play an essential role for any doctor’s office by addressing patient callers and providing the best dispositions for their care. This work can be performed during the day using a simple protocols checklist, or using more robust reporting and symptom protocols when the doctor’s office is closed. But what exactly does that look like? And how can these nurses provide consistency on every call? Here’s a full breakdown of that process.
The Patient
First, a patient calls a doctor’s office to discuss a symptom. An operator answers and documents the patient’s reason for calling by asking the most relevant questions. This information is forwarded to a triage nurse for them to review and to call the patient back.
The Call
Triage nurses are the same as any RN, and their duty to the patient begins as soon as they pick up the phone. By employing active, reflective, and empathic listening (explained further in this video), nurses are able to follow 10 critical steps to ensure that patient callers are all treated fairly, equally, and accurately:
- Introducing themselves.
- Collecting patient demographic information.
- Getting the patient’s brief medical history.
- Getting a history of the patient’s current illness.
- Identifying the chief complaint and the most serious symptoms.
- Selecting the correct triage protocol based on the patient’s symptoms (explained below).
- Triaging the patient based on that protocol, and getting them the right disposition of care.
- Providing care advice.
- Giving clear and specific callback instructions (in case the patient needs further assistance).
- Wrapping up the call and making sure the patient has no other questions.
Training
Because triage nurses can’t see their callers, they receive specialized training on how to elicit the most relevant information from them. This means asking patients about all of their symptoms, avoiding assumptions based on sex or age, and avoiding any behavior that could be construed as negligence. The most effective way to do this is by following established Schmitt-Thompson protocols.
Schmitt-Thompson Protocols
These are the gold standard of triage protocols that are already used by health systems, physician offices, and medical call centers across the US. Essentially, they act as a “decision tree” for nurses to review symptoms in decreasing order of severity. It’s important to note that these are not meant to diagnose patients, but rather, to determine the best level of care. For example, whether the caller should seek more urgent-based care from an ER or PCP, or whether home care is sufficient.
These protocols are also consistently reviewed, updated, and approved by an independent board of medical practitioners to ensure their relevance. The most recent version has been in response to the COVID-19 pandemic, which includes: symptoms and answers about infection, the ability to verify whether a patient is telehealth eligible, and the option to schedule telehealth visits on behalf of providers.
Triage Software
It’s also critical that triage nurses document patient interactions and reported systems by saving this data to each caller’s medical file. If a patient seeks a diagnosis from their primary care physician as a result of a triage disposition, their provider now has the most up-to-date information without having to ask them for it. This ensures continuity of care, avoids potential delays in care, and provides a more unified, complete health record. Our triage software does this and has the ability to integrate with any practice’s current EMR.
If you’re looking for ways to improve your own nurse triage, we offer the following services: the most current version of Schmitt-Thompson protocols, available for free; our own telephone triage software, which is easy to implement and comes with training from a nurse manager; and Nurse Triage on Call, our clinical and nonclinical call center support that can respond to patient calls 24/7. Let us know when you’re ready to get started.
