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Articles from AnswerStat

Patient Symptoms and Outcomes as the COVID-19 Epidemic Deepens in the USA


TriageLogic

Lessons from Nurse Triage Calls

By Dr. Ravi Raheja, MD 

As the coronavirus pandemic progresses, nurse triage plays a critical role in helping healthcare organizations, hospitals, and practices manage their overwhelmed systems. Triage nurses evaluate and direct patients to the best level of care for their symptoms. As the weeks passed since the original national emergency announcement, our nurse triage center has seen important trends on what callers experience. 

Traditionally, triage nurses use standardized protocols from Drs. Schmitt and Thompson to evaluate patients. Nurses can also use custom doctor orders to share handouts with patients, connect the patient to a doctor, or direct patients to appropriate local facilities such as drive-through testing centers. 

The coronavirus pandemic brought new concerns, new protocols, and new care advice that needed to be developed to help address patient symptoms. Nurses were quickly trained and given new guidelines to address patient questions as the problem unfolded. As we look back over these last several weeks, we’ve seen changing trends among callers and new issues arising that the healthcare profession will need to address.

Healthcare centers and hospitals are working hard to manage the extra care needed for the influx of COVID-19 patients. Click To Tweet

The First Two Weeks

We quickly saw a 30 percent increase in patient phone calls to triage nurses as news of the Coronavirus broke. During the first weeks most callers were worried and trying to understand which symptoms to look for. They asked questions about the virus, what precautions to take, and where to go for further help if needed. Overall, there weren’t many reports concerning symptoms related to COVID-19.

As time went by and the media began to pay closer attention to the virus and air all the details on news networks, we saw a swell of anxiety in our callers. While there were still not many callers who reported concerning symptoms associated with COVID-19, we started to receive more phone calls related to anxiety, depression, and suicide.

Updates on Caller Issues for the End of March and Early April

Our nurses have now received several calls from distressed patients who show the concerning symptoms of the virus. The nurses used the protocols to determine which callers now have symptoms that require further evaluation by a doctor. But while patients with COVID-19 like symptoms are told to seek the appropriate level of care and go to the hospital, a new issue emerged.

Patients are avoiding the ER due to worry about virus transmission. Unlike anything seen before, nurses find that patients who have serious symptoms that require an ER visit are refusing to go. These callers are reporting that they do not want to go to the hospital for worries about catching the virus from a hospital setting, or that they don’t want to intrude on an already burdened system.

Compounding the situation, after the caller is convinced to seek medical attention, hospitals may turn them away. This is either because the hospital is unable or unequipped to help. Some cities may also have facilities that are focusing on COVID-19 cases. Because of this, they do not have the capacity to help other patients. The confusion among patients about where to go to get help can increase morbidity. This is especially true with health issues such as chest pains, which hospitals regularly address and evaluate.

Healthcare centers and hospitals are working hard to manage the extra care needed for the influx of COVID-19 patients. Many cities have developed hotlines to help alleviate the workload of healthcare professionals and determine which patients need to be seen by a nurse. New solutions are being implemented daily as we learn more about this epidemic and how it is affecting our communities.

TriageLogic

Dr. Ravi Raheja is the medical director at TriageLogic, a leader in telehealth technology and services. The company’s goal is to improve access to healthcare and reduce costs by developing technology for providers and patients, backed by high-quality nurses and doctors.

Vendor Spotlight On TriageLogic


TriageLogic

Adapting to the Demands of Healthcare with High-quality Solutions for Nurse Triage and Remote Patient Care

In 2006 by Charu Raheja, Ph.D., founded TriageLogic with the purpose of using modern nurse telehealth technology and medical expertise to improve access to healthcare. Their goal is to ensure everyone receives the same standard of care regardless of where they live. Ravi Raheja, MD, serves as the medical director and COO, overseeing all nursing and technology operations in the company to ensure patients receive the highest level of care.

Over the last thirteen years, TriageLogic has stayed true to its mission and continues to provide innovative nurse telehealth technology and mobile applications. TriageLogic also operates one of the largest URAC-accredited healthcare call centers in the United States. As healthcare has evolved, TriageLogic has continued to adapt and release new product lines to meet the changing needs of the industry.

The year 2020 has challenged our healthcare system, causing many medical professionals to work around the clock to implement emergency remote support solutions for patients. TriageLogic has been proud to assist with the COVID-19 pandemic by quickly adapting and creating easy-to-implement solutions for hospitals, medical organizations, and health centers to use for patient care during the COVID-19 crisis.

The following lists some of the solutions available for clients:

Nurse Triage On Call

TriageLogic maintains one of the most sophisticated URAC accredited nurse triage systems in the United States. Their call center software allows clients to customize orders after nurses evaluate the symptoms presented by patients. Nurses can share handouts with patients on behalf of doctors, and MDs can communicate securely with nurses using HIPAA-compliant texting. The company quickly ramped up its services and software implementation as it observed a call volume increase by as much as 35 percent due to COVID-19.

Customized Coronavirus-Trained Hotline and Patient Triage System

These hotlines include a combination of online systems and a remote call center telephony with triage protocols. By partnering with physicians, TriageLogic helps millions of concerned callers, evaluate their symptoms, and coordinate testing for thousands of patients.

Remote Call Center with a Phone System for Doctors and Nurses

TriageLogic can set up nurses and doctors to work remotely, including connecting all staff to a call center-grade, HIPAA-compliant phone system. This system allows organizations to keep their clinical staff at home and coordinate as a team as if they were in the office. From front desk staff to nurses and doctors, the entire team stays together while working remotely, including scheduling visits and conducting telehealth visits. Using secure phone lines keeps patient information confidential.

Nurse Triage Software with Up-To-Date Protocols (including COVID-19)

MyTriageChecklist is a fast-to-train, web-enabled software from TriageLogic that provides continuity in patient care and education. It takes less than an hour to implement, does not store any sensitive patient information, and offers an easy-to-use interface to ensure nurses ask and consistently document all relevant questions related to patient symptoms.

It also includes triage protocols written by Dr. Schmitt and Dr. Thompson, which are updated in real-time. For example, COVID-19 protocols receive regular updates as information becomes available.

Remote Patient Monitoring (RPM)

As monitoring technologies continue to gain traction, the healthcare industry views RPM as a way to help control the cost of care for those with chronic diseases such as congestive heart failure, COPD, asthma, and diabetes.

However, the amount of data that’s generated by monitoring technologies is vast. TriageLogic has partnered with several device companies to create a full end-to-end monitoring system. The system makes it easy for doctors to monitor their chronically ill patients without adding administrative or clinical burden to their staff. TriageLogic can also create specific protocols for nurses to use based on devices and patient conditions.

Reporting Portal

Finally, all TriageLogic solutions come with a robust reporting portal to provide in-depth analytics on the outcomes from patient interaction. TriageLogic aims to stay ahead of the demands of healthcare and create ready-made and easy to implement solutions to continue helping providers give the best possible care to their patients.

TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide.

Emergency Medical and Continuity Remote Care Solutions to Address the Coronavirus Outbreak


TriageLogic

By Ravi K. Raheja, MD

The Covid-19 pandemic continues to change nearly all parts of our lives and businesses. As a result of this national emergency, medical professionals, hospitals, and organizations are working around the clock to implement emergency support solutions for patients presenting worrying symptoms as well as those who need help understanding the guidelines for care.  

This article focuses on emergency solutions that providers can implement quickly in this time of crisis.

Set-up a Virtual Doctor Office

We understand that virtual visits are going to be necessary to save time and decrease in-person patient contact. However, medical practices must consider how to create a system that allows medical visits to continue as if they were in the office. 

Here are some things to consider:

Doctors can evaluate patients over the phone and prescribe. Many practices already have the technology to see patients virtually, and there are several platforms available that healthcare providers, who do not yet have the technology, can implement quickly. When selecting a technology, choose a vendor that can provide HIPAA-safe calls, record information as needed, and make it easy to access without a mobile application.

Medical practices must consider how to create a system that allows medical visits to continue as if they were in the office.  Click To Tweet

Nurses play a vital role in helping contain the epidemic and alleviate the calls that go to the doctors. Nurses need to use triage protocols (including COVID-19 protocols) to evaluate and determine which patients require a consultation with a doctor. The protocols experience regular updates, written by doctors, as the latest information becomes available. These protocols are available for free from TriageLogic.

Software System

Look for a company that can quickly implement a virtual office that allows front desk, nurses, and doctors to continue working and operating remotely as if they were in an office. Vendors that have a record of working with doctors can implement these solutions quickly and affordably.

TriageLogic

Ravi K. Raheja, MD is the COO and medical director of the TriageLogic Group. Founded in 2005, TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. For more information visit www.triagelogic.com and www.continuwell.com or email support@triagelogic.com

Coronavirus and the Healthcare Call Center


LVM Systems

By Mark Dwyer

Healthcare call centers face unprecedented challenges in response to the Coronavirus (COVID-19) pandemic. At a time when efficient call processing is even more critical than usual, due to increased call volumes, call times have lengthened. Much is attributable to the plethora of misinformation individuals have readily available to them over the internet, via the media, and from family and friends. Now, not only do call center nurses need to calm the caller, they must correct the caller’s misunderstandings.

Add to this the pace at which medically valid updates occur. Triage call centers must keep up with the weekly, and sometimes daily, changes to the guidelines for handling possible COVID-19 calls.

COVID-19 has generated tremendous activity related to telehealth as a method of triaging and treating those who are infected. Given that COVID-19 symptoms can vary from very mild to severe and that the virus spreads through close contact, telehealth can be a powerful tool in combating the crisis.

Health center providers may now deliver in-scope services via telehealth to individuals who have not previously presented for care at a health center site and who are not current patients of the health center for the duration of this public health emergency. These include triage services with or without initial consultations. Some of the specific changes include:

  • Continuation of zero member liability (such as copays and cost-sharing) for care that is delivered via telehealth.
  • Any services provided virtually will be eligible for telehealth coverage.
  • All prior authorization requirements for telehealth services will be lifted for dates of service from March 17, 2020, through June 30, 2020.
  • Telehealth services may be delivered by providers with any connection technology to ensure patient access to care.
COVID-19 has forced healthcare to look at all aspects of its care delivery system. Click To Tweet

New Telehealth Policies Expand Coverage for Healthcare Services

Numerous states have taken steps to waive their requirement that a physician is licensed in the state to provide care to patients through their declarations of statewide emergency. More states are sure to follow.

According to Gregory A. Hood, MD, an internist in Lexington, Kentucky, who is on the advisory board of Medscape Business of Medicine, “The waiving of state licensure requirements should help ease a number of stress points of the current crisis in ways that benefit society.”

Healthcare providers, supported by states and payers, can leverage telehealth in ways not possible in previous epidemics to triage, diagnose, and treat patients while effectively protecting healthcare workers and reducing the spread of the disease. States that have broad authority as payers can play a crucial role in driving the use of telehealth as a method of treatment by implementing reimbursement policies that enable providers to offer virtual care services to patients.

Like many other aspects of the United States’ healthcare industry, when COVID-19 ends, the healthcare call center will never be the same. We will work smarter, more efficiently, schedule more creatively, and support more remote staff. We will embrace telehealth, tele-triage, and telemedicine with video calls, chat, and online physician consults.

More insurance companies will reimburse for online physician visits enticing more to participate. Triage call centers may also have more opportunities to work with EMS and police stations to help triage patients. Finally, data sharing will increase to the patient’s PCP into their EMR records or other approved endpoints. Data aggregation and reporting will enable call centers to analyze better yearly trends leading to heightened prediction and prevention of disease. 

COVID-19 has forced healthcare to look at all aspects of its care delivery system. May we all be the better for it. 

LVM Systems logo

Mark Dwyer is a veteran of the healthcare call center industry and serves as COO of LVM Systems.

Key Tips to Successfully Work from Home



Discover How to Effectively Work in a Home Office, Whether Long-Term or Short-Term

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

I recently celebrated twenty years of working from home. For the first year I divided my time between my home office and a traditional office. I followed that with a couple more years that included travel. But for the last sixteen years I’ve worked exclusively from home. It’s an ideal arrangement, and I wouldn’t have it any other way. In fact, I doubt I could ever return to a job that required me to go into an office to work each day.

Here are some of the key considerations to make a work-at-home scenario a success.

Workspace

A key element to effectively work from home is to have a dedicated workspace you can call your own. For me, an unused bedroom became my office. When I’m in my home office, I work. When I leave, I stop.

But not everyone has a spare room they can take over. If that’s the case, can you carve out a corner in another room? Can you make a room multifunctional, where it works as an office during office hours and serves as family space the rest of the time? Regardless, the goal is training yourself so that when you go to your office—whatever it may look like—you’re conditioned to work and not do anything else.

Distraction Free

Having a workspace without distractions is ideal, but it’s not always feasible. In that case, the goal is to reduce distractions is much as possible. Remove everything from your home office that you don’t need for work. This includes televisions, radios, and books. Delete games from your computer, as well as other programs that don’t facilitate work.

Many home workers buy a white noise machine, turn on a fan, or listen to instrumental music so they can tune out household activities that may occur as they’re trying to work. If you have an office door, close it. Post office hours in your work area. Then enforce them.

Expectations

Establish expectations with family and friends. When I began working at home, I told our young children that until 5 p.m. they were not to interrupt me for any reason unless they were sick or bleeding. That did the trick. Other family members were a bit harder to train, but the point is to insist that your family and friends respect your time in your home office as sacred and not assume you’re available for nonwork activities. This also means not answering your home phone or taking personal calls while you’re working.

Routine

Just as when you work in an office location and have a series of steps you do before work and after work, do the same for your home office. Though it’s quite feasible to do so, don’t work in your pajamas. It conditions you to not take work seriously or put forth your best effort.

Also, don’t eat meals or snacks in your office. Eat breakfast before you arrive, enjoy supper afterward, and leave your office for lunch. Doing so promotes focus, priority, and professionalism.

Tools

An effective office requires tools. First up is a fast and stable internet connection. I can’t think of a job you can do from home for long without internet access. Get the best that you can afford, and don’t let online access hinder your success when you work from home.

A slow or buggy computer is another detriment. Every second of delay or frustration at your computer provides time you’re not being productive. The seconds add up to minutes and minutes add up to hours. Again, get the best computer you can afford. Install all the same programs on your home computer as you have at the office. Don’t skimp.

Also look for tools that you may not use in your workplace office, such as Skype or Zoom so that you can connect with your coworkers as needed.

Schedule

If you’re work-at-home situation is direct contact center work, then your scheduler will tell you when to work. Easy-peasy.

For everyone else, establish your own schedule, just as you would in a workplace setting. You start at a specific time, end at a specific time, and take time out for lunch and breaks. The rest of the time you should be in your office working.

The converse of this is outside of your work schedule you should not be in your office working. This takes us to the final consideration.

Balance

We often talk about work-life balance. Though always a critical consideration, balance looms as an even bigger concern when you work and live in the same place. This means segregating your work from the rest of your life, even though both happen at the same location. Some people prefer the word compartmentalize: to place work in one mental compartment and your home life in another.

When done right, working from home can increase productivity, decrease stress, and improve your enjoyment of your work. Click To Tweet

Action Steps

If you suddenly find yourself working at home, put these tips into practice as soon as possible. Then you will experience a successful, enjoyable, and effective situation. 

If you’re planning to one day work at home, put these steps into place before you start. It will make all the difference.

When done right, working at home can increase productivity, decrease stress, and improve your enjoyment of your work. Though you might now be working at home as a temporary solution to a problem outside your control, you might find the results so beneficial that you want to turn working at home into a permanent scenario.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.

Good Clinical Documentation and the Telephone Triage Nurse


TriageLogic

By Heather Jarvis

When it comes to documenting triage calls, there’s always a fine balance between effective communications and liability risk. Nurses want to—and need to—effectively communicate information and directions to patients and those who may see their notes after the call. However, triage nurses must also cover themselves when it comes to liability.

So, what elements make good call documentation? Here are three tips to make sure your calls are well documented.

There’s always a fine balance between effective communications and liability risk. Click To Tweet

1. Make Your Communication Clear

Read your notes out loud and ask yourself, would this make sense to anyone else who reads it? Have I used the appropriate words? Does it have a definitive beginning and end?

2. Make Your Communication Concise

Think about what your narrative will look like to others. This applies not only to the next caregiver but six months or a year later when your instructions may face review. Are your communications direct and to the point?

3. Make Your Communication Credible

Use appropriate terminology, punctuation, and abbreviations. Make sure that others would view your documentation as written by someone who is knowledgeable. Always stick to the facts. Avoid jargon or slang. If a patient says she has a tummy ache, put that information in quotes so it’s known these were the patient’s words. Nurse triage documentation is not the place for personal views.

Conclusion

It’s important to remember that a nurse is judged by a reasonable standard: what a reasonable nurse would have done under the same or similar circumstances.

Every nurse wants to provide the best care, perfect care. But perfect care is not what the law requires. The law requires that a triage nurse provide reasonable care. Clear, concise, and credible documentation is always a best practice.

TriageLogic

Heather Jarvis is the communications and client engagement specialist at Triage Logic.

Vendor Spotlight on LVM


LVM Systems

LVM has served the healthcare call center industry for over thirty years. During that time, they have worked with many prestigious health systems, stand-alone hospitals, and other healthcare organizations. Throughout the years, they engaged their clients, learned what they wanted, and developed specific enhancements to address their needs. 

Today, their clients are asking them to develop solutions that place a high focus on integrated access to high quality, patient-centric care. Healthcare organizations, communities, and medical professionals face the challenging task of communicating patient care across all stakeholders while focused on the patient’s continuum of care.

LVM’s current healthcare call center system provides software solutions to support both clinical and marketing functions. Clinically, their software supports nurse triage, pediatric and adult guidelines, disease management, behavioral health, hospital/patient transfer, health information, and surveys.

On the marketing side, numerous clients utilize the physician referral, answering service, class registration, marketing outreach, web-based messaging, complaint management, and other components of the software. Some client hospitals use both the clinical and marketing capabilities.  

All these components exist within the same software, enabling clients to use them throughout their healthcare organizations. Clients utilizing LVM’s N-Centaurus software receive quality support upon which LVM has built their reputation. N-Centaurus remains a strong solution to meet numerous client needs. It will continue to do so for many years to come. 

Organizations looking for a fully integrated system that takes their current functionality and builds upon it, can look for LVM’s upcoming product release. Creating such a product has been their mission over the past three years, with the goal to produce an interoperable solution to meet the needs of LVM clients and their patients. LVM listened to the industry and their clients. Their new product reflects that effort. 

LVM rolls out its next-generation product that will take their clients’ organizations to the next level. Click To Tweet

Spring is the perfect time of year for new beginnings and refreshing new ideas. This spring will be especially notable for the industry as LVM rolls out their next-generation product. Although they can’t share the specifics quite yet (and spoil the product launch), know that this product will take their clients’ organizations to the next level. Users, however, need not worry. The functions and features they have come to depend on will still be there—just in a more integrated, system-wide way. 

Also, LVM has expanded the functionality of their existing software to increase its value. Clients will be able to relieve many of the stress points their patients experience when interacting with the client’s organization. No longer will patients feel lost in the myriad of touchpoints they must navigate to access an organization and receive services. No longer will they feel frustrated from not knowing simple things like where to park, where to register, or where to find the lab or radiology building. Simplified follow-up communications will enable patients to remember appointments, fill their prescriptions, and among other things, check their vitals.

As LVM looks toward the next thirty years, they see tremendous opportunities to assist clients in greatly improving the health of the country. LVM looks forward to sharing this experience with their clients. Although there will be changes, some things—like the ability to customize LVM’s hospital call center solutions and their high level of quality support services—will never change. 

LVM Systems logo

Learn more about LVM.

Contact Center Preventive Health Promotion


LVM Systems

By Traci Haynes

Preventive health has gained momentum over the past few years as individuals seek to improve their overall health through exercise, nutrition, mindfulness, and better lifestyle choices. Preventive care not only helps individuals and communities stay healthier, but it also helps to avoid or delay the onset of disease and keep conditions or diseases already present from worsening or becoming debilitating, resulting in a more productive life and reduced healthcare costs. 

Preventative Health Stats

According to the Centers for Disease Control and Prevention (CDC), preventive services are the most basic form of healthcare recommended for all individuals. However, they estimate that Americans only use preventive services at about half the recommended rate. 

More than 900,000 Americans die each year prematurely from the five leading causes of death (heart disease, cancer, chronic lower respiratory disease, stroke, and unintentional injuries). The National Center for Chronic Disease Prevention and Health Promotion says that between 20 to 40 percent of these deaths could have been avoided by taking preventive steps.

Not only is chronic disease the leading cause of death and disability, but it is the primary cause of our nation’s annual healthcare costs. In fact, 90 percent of our nation’s 3.5 trillion dollars in annual healthcare expenditures are for people with chronic and mental health conditions. 

The CDC believes that preventing disease is the key to improving America’s overall health and keeping rising costs under control. Click To Tweet

Overall healthcare costs, including all private and public spending, are anticipated to rise by an average of 5.5 percent per year over the next decade, growing to six trillion dollars by 2027. Healthcare spending is projected to grow faster than the economy, increasing to 19.4 percent of the gross domestic product (GDP).

As you know, many of the top risk factors leading to chronic disease and premature death are preventable such as tobacco use and exposure to secondhand smoke, lack of physical activity, excessive alcohol use, and poor nutrition, including diets low in fruits and vegetables and high in sodium and saturated fats. 

Most health plans must cover a set of preventive services (such as immunizations, screening tests, etc.) at no cost to the individual. Why? Because it costs less for insurance companies to pay for preventive care than it does to pay for all the associated costs for disease management.

Helpful Websites

The United States Preventive Services Task Force (USPSTF) makes recommendations for screenings, counseling services, and preventive medications based on a rigorous review of existing peer-reviewed evidence and is intended to help clinicians and individuals decide which preventive services are right for them. The recommendations are assigned a letter grade based on the strength of the evidence as well as the balance of benefits versus harms. The task force consists of sixteen volunteer members who are nationally recognized experts in prevention, evidence-based medicine, and primary care. Learn more about the USPSTF and view their list of recommendations.

Another excellent website is on healthfinder.gov, titled “myhealthfinder.” It includes a tool to find personalized preventive service recommendations for individuals simply by filling in age and gender. It also includes instructions for getting the tool for your organization’s or contact center’s website. 

The Call Center’s Role

What can the contact center do to help individuals learn about and receive preventive healthcare? Many things. The contact center can familiarize themselves with the recommendations for the population they serve and integrate the USPSTF recommendations, as appropriate, into their interactions. Here are four examples.

1. Chronic Cough: A 67-year old male caller who has smoked a pack a day for the past twenty-five years, calls complaining of a chronic cough lasting for weeks. After triaging the caller and providing the recommended disposition, the nurse should also advise the caller that an abdominal aortic aneurysm one-time screening is recommended for men ages 65 to 75 who have ever smoked and a lung cancer screening is recommended annually for adults 55 to 80 with a higher risk for lung cancer (heavy smokers or those who have quit in the past fifteen years). 

2. Low Back Pain: An adult caller complaining of low back pain and knee pain and who has a BMI of 37, should be advised regarding obesity screening and counseling recommended for all adults after being triaged.

3. Shortness of Breath: A 47-year old adult caller with shortness of breath and who has a high risk of cardiovascular disease and is not on a statin should be told about statin preventive medication recommended for adults 40 to 75 years of age with a high risk of cardiovascular disease after being triaged.

4. Flu Concerns: A caller, age 31 who is concerned about flu exposure, but has yet to be vaccinated should be advised that flu shots are recommended on an annual basis after being triaged. 

Other Opportunities: Additional uses include, if an individual is holding for the next available nurse, the automated attendant could promote preventive health recommendations or services. Preventive health could be on the organization’s website with a phone number for the contact center. Alternatively, callers could be provided the link for each individual’s gender/age preventive health recommendations in an email or text. The possibilities are endless. 

Conclusion

Being able to encourage preventive care screenings, immunizations, etc., and where to receive them may prevent further issues over time. It is our responsibility to guide individuals to quit smoking, eat healthy, get regular physical activity, avoid drinking too much alcohol, get enough sleep, make healthy choices, and get screened.

The CDC believes that preventing disease is the key to improving America’s overall health and keeping rising costs under control. We, as clinicians, must continue to drive the necessity for preventive health and help individuals reach their health and wellness goals.

LVM Systems logo

Traci Haynes, MSN, RN, BA, CEN, CCCTM is director, clinical services at LVM Systems.

What Kind of Healthcare Coverage Do You Provide to Your Staff?



Take Steps to Meet the Healthcare Needs of Your Healthcare Call Center Staff

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

I enjoy going to the zoo with family. We go several times each year. A special bonus are those opportunities to interact with the zookeepers and learn more about the animals under their care. During a recent visit we had the privilege of an extended discussion with one of the caretakers after she tended to the zoo’s three lions.

She shared insider information about their feeding, their training, and their healthcare. After covering the extensive medical care these three amazing creatures receive—the testing, monitoring, medication, and access to specialists—she grew momentarily somber. “They receive much better healthcare than I do.” We sadly nodded that we understood. Then she perked up and resumed telling us about these animals that she so clearly loves.

I wonder if a similar thing happens in our healthcare call centers. Do employees hang up from a phone call and shake their heads in dismay, muttering “That caller receives far better healthcare than I do.”? I hope not, but I fear it’s true far more often than it’s not.

It may be understandable for this to happen occasionally, but it’s inexcusable if it happens often. This needs to change. Take steps to better meet the healthcare needs of healthcare call center staff.

A key aspect of enabling call-center staff to best meet the healthcare needs of callers is to start by making sure you best meet the healthcare needs of your staff. Click To Tweet

To expect workers in healthcare call centers to serve patients and callers with excellence, they must first have a good perspective for them to work from. This includes providing healthcare workers with adequate healthcare coverage and services.

Falling short of doing so handicaps them from performing their jobs with distinction and serving callers with appropriate empathy. It would be like making restaurant staff work on an empty stomach but expecting it to not impact their patrons’ experience.

Call centers invest money on ongoing agent training, coaching, and quality assurance programs. Make sure to also invest in call center staff’s healthcare. This will help ensure that they better connect with the people they talk to on the phone, without negativity and resentment showing through.

A key aspect of enabling call-center staff to best meet the healthcare needs of callers is to start by making sure you best meet the healthcare needs of your staff. If you find yourself needing to make changes, you may not be able to fix everything all at one time. But you can move in that direction. Start today.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.

The Goal of the Telephone Triage Process



By Rose Moon, RN, BSN

Telephone triage processes are proven to improve access to care professionals, lower patient anxiety, save on ER costs, and prevent unnecessary health complications. The primary goal of the telephone triage process is to deliver safe, quality-oriented telephone triage partnered with outstanding customer service. The health, safety, and wellbeing of the patient is at the forefront of every telephone encounter. 

The purpose of the telephone triage process is to assess the patient’s current signs and symptoms, concurrently evaluating their past medical history and current medications. It performs the patient assessment in accordance with protocols which guide the nurse to determine the proper triage disposition to direct care to the safest, most cost-effective solution available at that time. 

Triage nurses don’t always have to be right; we just can’t afford to be wrong. Click To Tweet

To accomplish the goals of the telephone triage process, an organization needs to recruit, hire, train, and retain experienced telephone triage nurses. Two valued components that will result in quality patient outcomes are providing comprehensive, detailed orientation, as well as equipping the nursing staff with needed tools: gold-standard telephone triage protocols. 

However, the final determining factor of quality phone triage lies in the training of nurses to utilize the protocol tool properly. Anyone can read a protocol. It is the knowledgeable triage nurse who applies the following attributes of enhanced assessment skills, superior judgment, prior nursing experience, and exceptional decision-making abilities to the protocol tool that results in safe, quality outcomes and cost-effective patient care. 

Performing hands-on patient assessment allows the healthcare provider to visualize cyanosis, smell foul drainage, palpate an abdomen, and use a stethoscope to assess patients’ lung sounds. Telephone triage nurses don’t have such luxuries to assess patient needs. They’re limited to their ability to query and listen intently to the caller to obtain the necessary details of the patient’s medical symptoms and then direct medical care accordingly.

Successful triage nurses live by the following golden rules of the telephone triage process:

  • Every call is life threatening until proven otherwise.
  • Complete an ABCD assessment with every telephone encounter: Airway, Breathing, Circulation, Deficit (Neuro).
  • Assessing patients over the phone is high risk; therefore, take the callers word as truth. 
  • Follow your sixth sense: protocols are decision support tools; nursing judgment determines outcomes.
  • Know your patients’ medical history and current medications.
  • Assess your callers as well as your patients. Be a patient advocate.
  • Never provide a dosage of a medication without a complete patient assessment. 
  • Always confirm labeled dosage of a medication as well as the means in which the caretaker plans to administer the drug.
  • Always assess the caller’s level of comfort with the established plan of care before ending the call:
  • “Are you comfortable with these recommendations?”
  • “Now tell me what you plan to do next.”
  • If it isn’t documented, it didn’t happen. Use defensive documentation. Paint a picture.
  • Regardless of the reason for the call, always obtain a rectal temperature on an infant under the age of three months.
  • Document the exact mechanism of injury.
  • Be alert for red flags. Any time a caller uses or implies one of the following phrases be sure to clarify the underlying meaning. Carefully analyze your disposition and recommendation for follow-up care:
  • Grunting or moaning
  • Lethargic or listless
  • Sleeping more than usual 
  • Just doesn’t look right, act right, or is fussy
  • Sleeps through a rectal temperature
  • High pitched cry or unusual, funny cry
  • History of sickle cell or immune deficiency 
  • Frequent caller
  • Caller that expresses anxiousness or numerous questions after discussing a plan of care
  • Patient symptoms of headache, dizziness, disorientation, nausea, fatigue, or irritability; flu versus carbon dioxide exposure
  • At the conclusion of the patient telephone encounter, instruct callers to call back or seek medical evaluation if current symptoms become worse or additional signs and symptoms of concern develop.

Triage nurses don’t always have to be right; we just can’t afford to be wrong. Always err on the side of caution.

Learn more about telephone nurse triage and how to implement successful triage nurse centers by downloading the free e-book: Telephone Nurse Triage Handbook