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By Juliette Siegfried
When people have health concerns, particularly during the night, they may seek care from an Emergency Room because they are not sure about the severity of their or their loved one’s condition. Telephone nurse triage is a system by which trained nurses help patients with health concerns over the telephone before the patients go to the doctor’s office or emergency room. Telephone triage nurses must be well trained and have excellent communication skills in order to assess patients without the advantage of seeing them in person. Telephone triage nurses have excellent listening skills, to be able to determine the non-verbal clues from the patient about their condition and level of anxiety. They use their knowledge of symptoms and disease processes along with tested healthcare protocols to achieve an accurate understanding of the patient’s concerns and provide the best care advice possible.
It is important to note that telephone triage nurses do not diagnose patients. They use the information given by the patient along with established care protocols to determine the appropriate level of care. In many cases, patients do not need to go to the Emergency room and can implement home care until the next day when they can see their doctor. This saves time, reduces inconvenience and anxiety for patients, while saving on Emergency room costs and healthcare personnel that may be more needed elsewhere. The telephone nurse triage can direct patients to Emergency care if necessary or call the physician on call, provide home care advice, and book an appointment for the patient with the doctor.
The care protocols, or algorithms, telephone triage nurses use are developed and tested by physicians and other health care professionals with extensive experience dealing with a variety of diseases and conditions. The protocols provide the nurses with a series of questions and probes to help ascertain the patient’s condition based on symptom sets. Usually, the protocols begin with the most acute symptoms, in order to determine the severity of the situation and the need for Emergency care. In addition to symptoms, the protocols also assess demographic information, including age, height, weight, gender, etc. All information gathered from the calls is documented and some telephone triage services are able to integrate this information into the patient’s medical record.
In fact, some modern nurse triage systems allow the patient’s medical record to be retrieved during the call. Medication orders or other specific instructions are also included, and for ease of follow-up, the patient’s physician is notified through email of the calls and any instructions that were given. In addition, most telephone triage systems provide customization of the system to reflect the physicians in the practice and their preferences.
The nurses on staff at a particular physician practice can provide telephone nurse triage using specialized vendor software, or telephone triage can be outsourced to a vendor who provides remote, trained nurses for this purpose. The choice usually depends on the size and technical infrastructure of the health care practice or institution. Regardless of how a telephone nurse triage system is implemented, it has been proven to reduce costs while providing a high standard of care to patients, day and night, over the telephone.