Introduction to Telephone Triage and Protocols

Overview

• Presenter: Marcy Lying, Triage Logic Nurse Educator
• Focuses on the use of protocols in telephone triage to ensure standardized and appropriate patient care.
• Covers the history of telephone triage, its evolution, and the use of protocols.

Triage: Definition and History

• Definition: Triage comes from the French verb "trier," meaning to separate, sift, or select.
• Historical Use: Originated in the 1800s, used notably in wartime and emergencies to prioritize care.
  • Categories: Likely to live, likely to die, and those for whom immediate care affects outcome.
• Modern Use: Applied in disaster responses and in non-disaster settings such as hospitals and call centers.

Evolution of Telephone Triage

• 1960s: Nurses began using telephones for managing patient care.
• 1980s: Introduction of computerized guidelines and documentation tools.
  • Increase in nurse triage call centers.
• Recent Developments: Shift to remote work for nurses, challenges included HIPAA compliance and supervision.

Protocols in Telephone Triage

• Definition: Specialized algorithms evaluating the seriousness of a caller's condition.
• Purpose: Determine a safe and appropriate level of care.
  • Algorithms start with severe symptoms to those manageable at home.
• Tools: Comparable to a nurse's stethoscope; rely on experience and judgment.
• Utilization: Guides nurses in advising on home remedies, referrals, or appointments.
• Types of Protocols: Symptom-based, workers' compensation, pediatric, psychiatric, and OB/GYN.

Schmitt-Thompson Protocols

• Developers: Dr. Barton Schmidt and Dr. David Thompson
  • Schmidt: Professor of Pediatrics, developed protocols and software for pediatric care.
  • Thompson: Expert in emergency and internal medicine, authored various medical guides.
• Features: Symptom-based, not diagnostic, comprehensive coverage of symptoms, regularly updated.

Operation of Nurse Triage Call Centers

• Workflow:
  1. Patient calls are logged into triage software.
  2. A nurse retrieves the call, reviews patient info, and selects a protocol.
  3. Questions guide the nurse to determine care level.
  4. Plan of action is agreed upon and documented.
• Advantages: Faster response times, secure data handling, remote work efficiency.
• Technological Integration: Includes secure messaging, smartphone apps, and integration with EMR.

Benefits of Nurse Triage

• Patient Care: Ensures timely and appropriate care.
• Economic Savings: Reduces unnecessary medical expenses.
• Patient Satisfaction: Access to timely medical information and help.
• Physician Support: Provides relief and support during off-hours.

Conclusion

• Evolution: From manual processes to advanced technology-driven systems.
• Protocols: Provide a standardized approach, ensuring consistent and accurate advice.
• Future Learning: Upcoming courses will delve deeper into protocol selection and application.