Need your expertise

Telephone triage is an speciality. You might look into the Harborview Medical Centers phone triage system ( in Seattle). I went to grad school with someone who worked phone triage there- it is pretty complex - with an elaborate computer system to boot - and they certainly aren't caring for patients in between calls!

I was reading some of the other posts and gosh, the length of call really is an issue. I don't know how I am supposed to take care of patients in the unit and triage calls for 10-15 minutes a call. Is this the standard??? HELP!!!!!

You're not supposed to be taking these calls while trying to care for your patients in the hospital. Are they getting this service for free? The docs need either an answering service or need to contract with a telephone triage service.

You will also want to check with the hospital's legal dept about the liability of giving advice over the telephone...who's liable for a bad outcome, the hospital or the nurse? This is an important question, especially if the telephone advice/triage aspect is not a part of your written job description.

Just mention the legal liability concerns & the docs may very well back off.

Good luck to you.

You're not supposed to be taking these calls while trying to care for your patients in the hospital. Are they getting this service for free? The docs need either an answering service or need to contract with a telephone triage service.

You will also want to check with the hospital's legal dept about the liability of giving advice over the telephone...who's liable for a bad outcome, the hospital or the nurse? This is an important question, especially if the telephone advice/triage aspect is not a part of your written job description.

Just mention the legal liability concerns & the docs may very well back off.

Good luck to you.

Yes..they do get this for free. They do have a service...but when the patient calls the office after hours..they get our phone number in L&D. Their service number is listed last...long after the patient has gotten our number. The reason they want this is so they aren't bothered. Their stand now is that nursing should be able to do triage and if we don't...we are getting our "power" taken away from us...so much so that techs could do our job. Believe me...my blood still boils over that comment.

Thanks for your imput. I am learning so much about all of this.

Are there standards that I could get to that you know about concerning telephone triage??

Thanks again

Hi,

I read your post and I would recommend 2 websites that may be of help to you:

www.teletriage.com and www.carolstock.com

Sincerely,

Sharon in Sacramento, CA

The legal department will probably make the final decision based on the liability issues.

Telephone triage requires documentation, just as in any other aspect of care. Do you document these calls? What has been your unit's policy?

Good luck.

I need some help and I am hoping you all can lead me in the right direction. Currently we are trying to set up policy and procedure for telephone triage for our labor and delivery unit. One of the two practices that delivers at our hospital refers after hours calls to L&D. We have fielded their calls for years. We triage anything from labor to medical issues for the pregnant woman. We also get calls from moms of newborns with issues. Recently we changed directors and she feels that it is not our place to triage calls from this practice. What a stink this has created. Of course the docs in this practice are unhappy and are now creating a huge drama surrounding all of this. One doc just can't understand why triage is such a big deal...there is no liability in it. Ok..you can close your mouths now.

In reading your forum and the research I have done, he is nothing but WRONG. I have learned tons by just reading what you all have here. What I am looking for is literature for evidence based practice for telephone triage...specifically to L&D. I have books and articles and have done some research on the legal angle and found many many cases concerning triage over the phone. This is a huge issue for our unit and I am heading up a committee to put down in writing to do's and don'ts. What I am really looking for is a documentation tool for these calls. ANY and all help would be soooo appreciated.

I was reading some of the other posts and gosh, the length of call really is an issue. I don't know how I am supposed to take care of patients in the unit and triage calls for 10-15 minutes a call. Is this the standard??? HELP!!!!!

I do have a form that can be used for telephone triage documentation. If you'd like to contact me directly, I'd be happy to discuss it with you and see if you think it might meet your needs. And incidentally (for what it's worth), I think you are absolutely on the right track! There is SO much liability associated with doing telephone triage wrong, especially in a high-risk area like L&D.

Good luck!

Carol Rutenberg

[email protected]