Quality/Length of Call

[kst]

Our call center of 7 RN's perform nursing triage in addition to physician referral for the general public. Our focus has been on quality of care and customer service. We use medically approved algorithms, computer based. We have been under great pressure financially as we are supported through our health system's marketing departement, which in turn supports 14 hospitals. We are having to shift focus on cost per call and length of call. Our avg length of call is 15-20 minutes and we are being told to cut out part of our usual process (which includes taking a brief health history for all triage callers), rush through calls, and go to an average of 6-7 minute length of call. I would like to hear if any other call centers are facing these same challenges. Concerns are safety and legal risk as well as compromising good customer service. Our legal dept is telling us that telephone triage nurses do not have a "nurse patient relationship" with callers and so risk is minimal. My understanding is that as soon as a nurse identifies herself as a nurse and gives care advice over the phone, there is established a nurse-patient relationship and she can be accountable for care just as a nurse in any other setting would be. Comments?

[daubney]

I have had employer allegations of unsafe practice in regard to telephone triage. The chart time was used ie. the time the file was open from beginning of call to the end of the discussion with a supervisor - long after the call had been dispatched. The phone time record or the time on the chart of advising the client to be seen was not considered. Used the system for 4 months.