Tag Archives: telephone triage articles

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.

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.

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

How Triage Nurses Can Help Patients with Mental Health Conditions


TriageLogic

By Ravi K. Raheja

Telephone triage nurses have a more important role than ever before. Nearly one in five U.S. adults lives with a mental illness (44.7 million in 2016), which is why many adults with mental illnesses go untreated (60 percent according to a report from USA Today). This article addresses the growing concerns for mental health awareness and education.

Telephone triage nurses are often the first point of contact for those struggling with a mental illness and can help a patient recognize the need for intervention. So, what can telephone triage nurses do to help?

Provide Accurate and Timely Triage

Telephone triage nurses are often the first point of contact for a patient with mental health symptoms and as a result, nurses should be patient, flexible, and have great communication and listening skills. The nurse must combine both clinical judgment and emotional connections to assess the patient’s situation to identify possible mental health issues. The telephone triage nurse’s role is to obtain the most accurate medical history and assessment to rule out medical symptoms that require immediate attention.

Remove Biases That Can Impact the Triage Process

Good telephone triage nurses always remove any biases and stereotypes. Having preconceived notions and distinctive sets of thinking can lead to error in the treatment of patients.

Assess the Environment

The Emergency Nurses Association recommends treating patient agitation as if it’s “the chest pain of behavioral emergencies.” Key phrases such as “I understand” can help place a patient at ease and give them the space to talk to the nurse. Throughout the call, the nurse should assess the patient’s environment and resources available to determine the most appropriate care plan.

Manage Uncertainty

Not all patients will be able to accurately describe their condition, history, medical conditions, or other pertinent information. It is up to the nurse to decipher this uncertainty.

  • Assess the situation: How is the patient presenting? Is his or her speech coherent? Are they answering questions appropriately? Hallucinating? Delusional? Rambling?
  • Address the whole patient: One common occurrence within mental health care is “diagnostic overshadowing.” This happens when the focus on a patient’s mental health diagnosis overshadows their physical health needs.
  • Be an advocate: Triage nurses are the first to communicate with, provide support to, and manage patients with psychiatric or mental health issues. Acting as a patient’s initial advocate can be life-changing for that patient

In Conclusion

Triage nurses always have the callers’ safety in mind. They combine both clinical judgment and emotional connections to assess the patient’s situation and to identify possible mental health issues. Nurses need to know the local emergency assistance numbers in case they need to reach out for more assistance. Just talking about their problems for a length of time can help a great deal for many callers who might be suffering from a mental illness.

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. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com and www.continuwell.com.

Using Device Data and Nurse Triage to Improve VA Healthcare


TriageLogic

By Ravi Raheja

New technologies are transforming how clinicians deliver healthcare. At the same time, digital solutions alone are not enough to help patients. Incorporating some human component increases patient compliance and education, further reducing healthcare costs. Medical call centers should be adopting software and increasing the role of triage nurses to complement traditional care settings, such as the VA. 

Device Data

For example, digital diabetes prevention and treatment platforms connect users with support communities and health coaches who can remotely monitor chronic conditions such as weight, blood sugar, diet, and medicine intake. Thresholds and alerts can be set up to alert healthcare providers about abnormal and potentially abnormal or dangerous values. While the devices can collect and transmit data and even have a certain threshold, a medical professional still needs to interpret the data and then direct patients about the next steps based on the data and in the context of their symptoms and current health status.

New technologies are transforming how clinicians deliver healthcare.  Click To Tweet

Telephone Triage

Telephone triage nurses play a vital role in interpreting the data and providing appropriate follow up for patients who use these technologies. They act as the first line of screening when an alert or abnormal value is reported. They have the training to talk to patients, assess their symptoms, and determine the next best steps based on combining the data with the full patient assessment over the phone.

To assess patients and direct them appropriately, the nurses need triage protocols. Most medical call centers use the gold standard protocols from Schmitt-Thompson to assess symptoms. Call centers should also incorporate robust protocol builders, a technology that enables an organization to modify existing protocols to meet their needs and create new protocols when required.

Custom Protocols

By using custom-developed protocols, triage nurses can assess a patient using the data received from devices with appropriate next steps for medical care. As a result, triage nurses play a significant role in this new digital era, driven by value-based care. By combining the data from devices and other sources with innovative triage technology, triage nurses can act as the bridge between patients and providers. This creates a viable monitoring solution that provides cost-effective care.

In conjunction with the custom protocols, organizations should use platforms to put in custom workflows. As an example, once a nurse has determined the appropriate level of care, they can now further direct the patient to specific care locations, referral numbers, or provide handouts via text or email. This allows the triage nurse to serve as an effective first point of contact and get the patients to the appropriate next steps on the first call.

Mobile App

Finally, look for companies that can provide an optional mobile app to enable patients to take advantage of increased self-service, access to customized resources, and insight into their own information.

Summary

Technology is changing the access, monitoring and delivery of healthcare. Value-based solutions are now possible to optimize patient care and decrease healthcare expenses.

Call center solutions that incorporate effective communication using telephone triage nurses, coupled with valuable wearable device data, will be able to greatly improve the level of VA healthcare services for veterans and their families.   

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. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com and www.continuwell.com.

Using an Outsourced Telephone Triage Service for Suicide Prevention


TriageLogic

By Ravi K. Raheja, MD

Telephone triage nurses play a critical role in suicide prevention and serve as the first point of contact for callers in need of immediate assistance. According to the CDC, 123 Americans die by suicide every day, and for every person who dies from suicide every year, another 278 people think seriously about it but don’t kill themselves.

As the demand for mental health services grows, practices are turning to outsourced telephone triage call centers to support their practices. Call center triage nurses trained in treating patients with mental illnesses are better prepared to intervene and often alleviate lengthy interruptions to the normal call flow of a practice.

Common Warning Signs Of Suicide

  • Talking about wanting to die or to kill oneself.
  • Looking for a way to kill oneself.
  • Talking about feeling hopeless or having no purpose.
  • Talking about feeling trapped or being in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious, agitated, or reckless.
  • Sleeping too little or too much.
  • Withdrawing or feeling isolated.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

What Can Triage Nurses Do to Help?

Triage nurses need to find a connection with the patient. They combine both clinical judgment and emotional connections. Click To Tweet

In moments of crisis, connecting with a trained triage nurse can deescalate the suicidal crisis and provide immediate help. It is never easy to talk about suicide, but it is crucial for triage nurses to be comfortable talking about suicide in the same way they talk about chest pain. How they handle each call can be life-changing for the caller.

Triage nurses need to find a connection with the patient, find the patients local emergency assistance numbers, and be ready to involve all resources available to help prevent this patient from harming him/herself.

It is essential for the triage nurse to be sympathetic, non-judgmental, and accepting. The caller has done the right thing by getting in touch with another person. No matter how negative the call seems, the fact that it exists is a positive sign, a cry for help.

Triage nurses always have the caller’s safety in mind. They combine both clinical judgment and emotional connections to assess the patient’s situation to identify possible mental health issues.

Even though remote triage nurses typically can’t see their patient, they must develop that all-important trust quickly and by means other than visualization for the caller to open up and be honest with the nurse. Not all patients can accurately describe their condition, history, medical conditions, or other pertinent information. The telephone triage nurse must decipher this uncertainty.

Sometimes the patient needs emergency treatment, while other times they are reaching out for someone to talk with and work thru difficult situations like substance abuse, economic worries, relationships, sexual identity, getting over abuse, depression, mental and physical illness, and loneliness.

Just talking about their problems for a length of time gives some suicidal caller’s relief from loneliness and pent up feelings, an awareness that another person cares, and a sense of someone understanding them. Also, as they talk, they get tired and their body chemistry changes. These things take the edge off their agitated state and help them get through a bad night. Suicide calls can be difficult, but with proper training, protocols, and disposition, telephone triage nurses save lives, one call at a time.

TriageLogic

Ravi K. Raheja, MD is the CTO and medical director fo the TriageLogic Group. Founded in 2005, the TriageLogic Group is a URAC accredited, physician-lead 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 assists their clients with value based care and serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com. and www.continuwell.com.

Oklahoma Medical Center Provides Innovative Triage Line to Manage Hospital Overcrowding


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An Effective Approach to ER Phone Calls

Dr. Charu Raheja

Emergency Room (ER) overcrowding is widespread in hospitals, creating delays and diversion from those who need care the most. According to a recent article, “Compounding the problem is the alarming trend of a decreasing number of ERs and an increasing number of ER visits.”

All too often, injury or illness appears without warning for patients. For hospitals trying to control overcrowding, the obvious solution is to redirect patients who don’t need to be in the ER to more appropriate paths for care. Who then determines if it’s necessary for a patient to go the ER? Most people aren’t trained medical professionals, and as a result, they worry and end up in the ER for non-urgent symptoms.

Having the reassurance of a triage nurse could help decrease the number of people in the ER for non-emergency reasons. Click To Tweet

Patients faced with uncertainty about where to go, all too often, end up calling the ER department and receive a standard response: “We are not allowed to give advice over the phone. If you think you have an emergency, please hang up and call 911. If you think you need to see someone, you can come to the emergency room or call your doctor.”

So, who do you call?

Telephone Triage

One hospital in Oklahoma, with a similar issue, wanted to change this process. What if they provided a nurse triage line that would be available to receive calls from the patients calling the ER? Having the reassurance of a triage nurse could help decrease the number of people in the ER for non-emergency reasons.

This would provide patients with quick and easy access to a trained medical professional to assist in determining the appropriate next steps based on their symptoms and medical history. Also, since the nurses work independently from the hospital system, the nurses would provide an objective opinion increasing patient trust.

Results

The results were inspiring. The nurses significantly decreased unnecessary emergency room visits. A random survey of about 520 patients uncovered their plans before talking to a nurse. This helped determine the effectiveness of the system.

Out of 240 patients who were planning to go to the ER, 42 percent of them were diverted to a lower level of care, including 17 percent that received home care needing no additional follow up actions. This translated into a savings of at least 215,000 dollars in unnecessary ER visits, not to mention providing peace of mind for patients being able to stay home and rest.

Better Health Outcomes

The benefits didn’t just stop at ER costs savings. Consider the patients who called into the nurse triage line and were not intending to go to the ER. Some medical conditions are considered emergencies because they require rapid or advanced treatments.

Surprisingly, close to 20 percent of the patients who called into the nurse triage line had symptoms that were serious enough to warrant a visit to the ER. Without the nurse line, the outcomes for these patients could have been life threatening or fatal.

Conclusion

While nurse triage has shown significant effectiveness in an outpatient setting, this preliminary data shows even greater promise to expand this model to emergency rooms around the country.

Providing local communities with a nurse triage program not only prevents unnecessary ER visits and saves on healthcare costs, but it also ensures patients get appropriate care when a serious symptom arises. For the hospital, this increases goodwill in the community while addressing the overcrowding of the ER: a win-win all around.

TriageLogic

Dr. Charu Raheja is the co-founder and CEO of the Triage Logic Group. Charu’s personal struggles and triumphs with her health define both her personal and her professional mission. Most recently, her experience in overcoming a life-threatening health event led her to launch the Continuwell brand. The TriageLogic Group provides telehealth software, mobile communication solutions, and services to large medical centers and businesses around the country. It is part of the Women’s Business Enterprise National Council (WBENC), and it covers over 25 million lives nationwide. Visit www.TriageLogic.com or contact Amy Smith at 888-TEAMTLC for more information.

Reduce Physician Burnout with Telephone Triage Nurses


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By Dr. Ravi Raheja

Physicians today are experiencing more demands on already busy schedules, and it’s taking a toll on their personal health and professional accuracy. According to recent studies, more than half of physicians report burnout, which is defined as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. However, establishing a telephone nurse triage service for patients, can alleviate some of this stress and exhaustion.Doctors experiencing burnout have higher levels of divorce, depression, alcohol and drug addiction, and suicide. Click To Tweet

Effects of Physician Burnout

 While job burnout may not seem like a serious issue, it can produce critical circumstances when it involves a physician. Reports claim doctors experiencing burnout have higher levels of divorce, depression, alcohol and drug addiction, and suicide.

Additionally, they have lower levels of clinical care quality and patient satisfaction and higher levels of medical errors and malpractice risk. Medical errors are estimated to be the number 3 cause of death in the United States and annual costs for medical mistakes are estimated to be between 17 and 30 billion dollars. The U.S. healthcare system cannot afford the financial effects of physician burnout.

Better Work-Life Balance

When a physician is on call after office hours or during the weekend, they often receive patient calls interrupting personal time with family or getting needed rest. It would be easier to manage if these calls were rare, but the reality is, patients need access to healthcare professionals 24/7 to avoid unnecessary ER visits. Many of these patient calls regularly result in advice that could have been given by a nurse.

Technology can help minimize the burden. Utilizing telephone nurse triage, physicians can ensure that patients are receiving prompt, quality care based on standardized protocols combined with custom orders. As a result, many physicians who use telephone nurse triage find that their phone doesn’t ring as often after hours, they’re able to spend more time focusing on their patients during office visits, and they can be confident everything is properly recorded in the computer for efficient billing.

There is no single solution to eliminate physician burnout. Providing work-life balance education early in their careers and offering continuing education and assistance for stress management can help many doctors. Additionally, telephone nurse triage provides a flexibility that allows physicians to adjust their schedule more easily to create a better work-life balance and avoid burn-out.

TriageLogicDr. Ravi Raheja is the medical director at TriageLogic, which is 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. The TriageLogic group serves over 9,000 physicians and covers over 18 million lives nationwide.

Why Telephone Triage Nurses are a Perfect Complement to Telemedicine


TriageLogic


By Charu Raheja, Ph.D.

Telemedicine has been a medical buzzword for several years, and the variety and depth of services provided have grown dramatically during this time. There is little argument that telemedicine is a great way to supplement traditional medical practices.

The advantages are clear: more convenient care for patients, more doctor availability, and less driving time and waiting-room time. But like any other new evolving field, there is still a learning curve and a need for developing a process that makes telemedicine viable, profitable, and doesn’t require doctors to work 24/7 to meet patients’ requests.Telephone nurse triage allows a practice’s telemedicine program to work seamlessly, whether the office is open or closed. Click To Tweet

One of the biggest hurdles for doctors is that their time with patients is limited. In a traditional office setting, doctors have a nurse start a patient visit before the doctor comes in. Nurses take vitals, talk to patients, and evaluate their needs before a doctor walks in the room. The same type of process needs to be designed for telephone medicine, with the difference being that the nurse will do her job over telemedicine, just like the doctor.

First, some practices have nurses in their office taking patient calls and scheduling visits with a doctor. When managing these calls, the nurse needs to perform two tasks. First, the nurse must evaluate whether or not the patient needs the doctor at all or whether the nurse can help the patient over the phone with home care advice. Second, the nurse must document patient symptom information before making the appointment for the patient to speak with a doctor.

This is where having a good platform to document patient calls and ensure standard protocols comes in. This can ensure patient safety and help make the process efficient. Medical protocols such as Dr. Schmitt and Dr. Thompson’s protocols ensure a standard care every time a nurse takes a call. These protocols are also available electronically, making them easier to use as compared to textbooks. The electronic protocols can also allow the care advice to be documented directly on the patient chart for review by the physician during the telehealth visit.

However, not all doctors offering telehealth services have their own nurses always available to answer patient calls when they first come in. An alternative for these doctors is to hire a telephone nurse triage service. A nurse triage service can serve as an extension of the office by providing patients with a trained nurse to evaluate patient symptoms and determine what actions to take.

What sets a high-quality telephone nurse triage service apart is the ability for the physician to have custom orders and preferences built into the system so that the nurses can act as a true extension of the physician. A high-quality nurse triage nurse service is also able to schedule the patient appointments for those patients who need an appointment.

Providing patients with access to triage nurses can also be helpful for those doctors who don’t have the ability to provide telehealth services 24/7. If given the appropriate instructions, triage nurses are typically able to resolve over 50 percent of the callers’ issues without the need of a doctor.

Figure 1 comes from a survey of over 35,000 patient phone calls. In over 50 percent of the cases, the nurses were able to resolve the caller’s medical symptoms by giving them home care advice. These nurses were also able to determine which callers required a physical visit to an urgent care or an ER (in an event of an emergency, such as symptoms of a potential heart attack).

Telephone nurse triage allows a practice’s telemedicine program to work seamlessly, whether the office is open or closed. Setting up a nurse triage system where nurses use standardized protocols to answer patient questions increases the productivity and profits for your practice.

When your nurses use triage protocols, you can have the confidence that they are asking the right questions and not missing anything. The basic patient information, the protocols used, and the nurse notes can also be used as a quick reference for the physician prior to the telehealth visit similarly to the notes that the doctors receive when their nurses see a patient before them during a physical office visit.

TriageLogicCharu Raheja, Ph.D., is the CEO of TriageLogic a leading provider of quality, affordable triage solutions, including comprehensive after-hours medical call center software, day time triage protocol software, and nurse triage on call. Customers include both institutional and private practices. If your hospital or practice is looking for information on setting up a nurse triage service, contact TriageLogic to get a quote or set up a demo.