Quality/Length of Call - page 3

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... Read More

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    Quote from 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?
    There definiely is a relationship. It starts as soon as you assume your nurse role.

    Our goal is to have our calls be 10 min with 2 min clean up time.

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    I think you are right re duty to care from a legal asspect. I share your concern re omitting a history and rushing calls. Tell me more.
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    6 minute calls? 6 per hour? thats just unsafe and yes you can get sued for your medical advice. We were encouraged on the triage line for 3-4 per hour. we had protcols to follow and if EVER in doubt the call went back to the pediatrician. we had clear guidelines for 911 or ED now, there was also a loop hole for nursing judgement. i was able to do 6 an hour easy since i had done this for 15 years but only in a crunch. we had our system pretty set up for flu season, nurses taking call from home, a nurse on call to come in if someone called in sick for flu season, if we got 1 hour behind calls went back to the pediatrician.
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    Using the McKesson system where the nurse /opens the file(time dated) Records the name and data of the client as well as that of the parent if parent is caller/then links the two together in the data base/then types the presenting problem/Then completes a history screen/ Then asks triage questions using a yes-no or ana button. Once a yes button is pressed the screen progresses to a predetermined outcome page that indicates what the client should do ie 911/ER/family Doc/Home care and may also have advice. If anyone is familiar with this process PLEASE RESPOND I have critical questions.
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    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.


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