I work in a physician owned/run clinic with Family Practice drs, Urology, ENTs, Neuro, Internal Medicine, OB/GYN, Surgery, Orthopaedic and Sports Med practices. We have one (1) Triage Nurse for the entire facility. I am the Ortho/Surg nurse and at one time in addition to being the Ortho Nurse, I was the Triage, and Urology Nurse. We recently hired a nurse to specifically do Triage. The sheer volume of calls and walk-ins is staggering and impossible.
*The current process is...the receptionists take a brief (sometime illegible) message, call for the chart, then the chart with message is placed in a wall mounted chart rack made to hold one chart...usually 5 charts are crammed in it, with 5-8 stacked on the floor below it. Then the Triage Nurse, keeping a frugal eye on the "box" comes by to retrieve the stack and begin the process of deciding who to call first to see what exactly they need or the problem is. After making a few calls, she is paged to another department to take a B/P on a walk-in, or give an allergy shot or B-12 inj, or hunt for med samples for a patient. All the while the "box" is filling with more messages, people she called ealier but did not answer are calling back after recieving her message...etc etc. Then she stacks the reviewed charts into piles of urgency. Then has to go to the dr of that particular pt to ask course of tx. But at that time the dr is in a room seeing his scheduled pts. So she stands waiting for the chance to pounce the minute the door knob twists. Then at the end of the brutal day...after walk-in head lacs, spotting OB's, sick babies, and running errands for all the other nurses...she then starts to delve into the mountain of charts of pts req med refills. Finally, document everything she did for each pt.
The one thing we have established that facilitates a bit of expedience is, obtaining standing orders from most of the drs. This allows her to just flip through the dr list and see his req and if labs and visits are up to date can call in the refill without having to wait for him to verbally Okay. All in all our clinic Triage is horrid.
I have read the above posts and though mostly directed at hospitals, I can draw some valuable tools for the trade. I would welcome any and all additional input toward Triage. Ideas that promote timely response, appropriate, streamlined questions to ask the pt calling, and ideas for forms/systems that allow for pt satisfaction and adequate information for tx.
[This message has been edited by Jo_deye_yuh (edited July 28, 2000).]