Telephone Triage... what is your policy?

[jennobrn01]

We are working on a telephone triage policy on our unit. RN's have done telephone triage in the past, and we are now working on documentation of our t.t.

Some questions:

Do RN's on your unit do telephone triage?

If so, what is the mode/method of documentation?

We are looking at using algorhythm's.

Do you use this method, and what are your opinions about it?

Any other views/opinions/research about RN's doing telephone triage is welcome!

Thanks much!

Jenn

[jeepgirl, LPN, NP]

we DON'T do triage. period.

we tell them to call our triage hotline our docs pay for. if it is a doc that doesn't pay to that service, we tell them if they are uncomfortable to call 911 or go to the er.

[SmilingBluEyes]

Unfortunately we do triage on the phone, but it is VERY limited. Tele triage is rife with risk, as you know. Most of the time we just tell them to COME IN as we can't see over the phone what is going on. Our hospital's nurse triage line no longer exists (risk management issues, I believe). I also have been known to have them call the doctor's answering service to get in touch with MD's for issues the MD's should handle. Then the docs can give them scripts if needed, or direct them to our ED or labor/delivery, as needed. We really try to stay out of telephone triage business, in other words.

[SmilingBluEyes]

There is a GREAT OB triage book out there which may help you with algorithms. Here it is:

http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?userid=In0Ri5JAu6&isbn=0721692249&itm=2

good luck to you. Be sure your risk management's blessing is on whatever you choose to do and dont' forget to stick to AWHONN standards of care (if in North America).

[jennobrn01]

Thanks for your help, and the link.

I would like to hear from more of you on this one though! :)

This is an issue we are working through now in our facility. Our new nurse manager would like to discontinue telephone triage, while the ob's would like to continue it with better documentation.

Any other opinions/experience?

[palesarah]

we don't do it- pts call their provider's answering service, and whoever is on call for the practice calls them back and triages them.

I'm happy with it.

[SmilingBluEyes]

Have you discussed tele triage procedures and issues with your risk managers? Perhaps with them, and the docs, you can develop an algorithm that works for you, and for which you are covered well!!!

Good luck!

[jennobrn01]

Sarah B.,

That would be ideal. But during the middle of the night we are afraid of what our docs repsonse would be to this method.

I am helping in bench-marking, so I am not sure if risk management has been involved yet. This venture is only a few days old.

Thanks much for your responses.

Jenn