Contributed by Gina Tabone MSN, RNC-TNP
The Five Undeniable Truths about Nurse Triage
Telephone triage has been around since the 1960’s, but never has it been as relevant and respected as it is today. If your organization has committed to the specialty practice of dedicated RNs caring for patients remotely, or you have been tasked with looking into bringing that type of service to your organization, there are five crucial facts that need to be communicated to your organizational decision makers.
- Telephone nurse triage is safe.
It is grounded in Standards of Care that have been developed by the American Association of Ambulatory Care Nursing (AAACN). Telephone nurse triage is performed by specially trained registered nurses with an average of 5 to 10 years of experience in Emergency and Primary Care, Medical Surgical Nursing and Pediatrics. Practice is guided by evidence-based clinical guidelines which are physician approved and updated annually. There are several options when selecting the best decision support tools for your patients, but the common denominator is the fact that these are guidelines and not algorithms. Qualified registered nurses understand the need to apply critical thinking skills developed in prior roles when taking care of patients remotely. The ability to observe, palpate and smell are not an option available with remote care, so expertise in astute active listening and therapeutic communication is critical. Quality Assurance monitoring of nurse triage calls indicates that in 97% of the encounters, telephonic triage recommends patients to the safest level of care.
- Nurse Triage contributes to optimal outcomes.
Triple Aim sets the bar for all healthcare providers. The Institute for Healthcare Reform (IHI) identifies the dimensions of Triple AIM: improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care. Triage Nurses are caregivers who can significantly contribute to the fulfillment of these goals. After-hours triage care for each patient is done on a 1:1 basis. It is foundational to most primary care practices, is extremely cost effective, and generally assimilates services and information across enterprises. Improved outcomes require your patients have access to telephone nurses, so make sure this information is shared with your administration.
- An exceptional Patient Experience is an integral part of optimal outcome goals.
A sign of an organization that is committed to providing exceptional patient experiences is one that provides their patients with access to 24/7 nurse triage services. Today’s healthcare marketplace holds patients in the same regard as consumers. Market studies indicate today’s consumers want what they want when they want it–including clinical care. In the recent past, the only option to receive acute medical care was to go to the Emergency Department. That is no longer the case for organizations that provide their patients with the option to speak directly to a triage nurse at any time. Telephone triage nurses conduct assessments of patients’ current health issues and tell the patients what they need to do and provide a timeline for care. In many cases, the outcome does not involve a trip to the ED. Patients don’t need to leave their homes, drive across town to a network facility or wait in a crowded waiting room for hours waiting to be seen. Telephone Nurse Triage can definitely enrich your patients’ experiences while providing optimal outcomes.
- Executive Leadership needs to give ample consideration to the either maximizing or investing in a medical call center that is committed to continuous clinical care.
ROI valuations are impressive and varied–depending on whom you ask. There is no denying the fact that a triage model that pays an RN an average of $30 per hour with an expectation of handling four triage calls during that time is a bargain when compared to other options available. The initial investment can be perceived as costly, mainly due to the fact that purchasing call center technology is necessary. One way to dilute initial expenses is to consider partnering with an outsourcing medical call center company that can seamlessly provide telephone nurse triage to your patients. Many healthcare organizations have made permanent outsourcing arrangements, reaping all of the benefits of a nurse triage model with no capital expenditures. Telephone Nurse Triage is an investment, not an expense.
- Nurse Triage provides a worthwhile solution to the challenges The Affordable Care Act has bestowed on caregivers.
We’ve already discussed the role nurse triage plays in achieving success as measured by the Triple Aim. Offering 24/7 nursing triage care can augment the role of newly-created care coordination teams. Additionally, 24/7 service can be provided to ensure patients are not at risk of escalating to a higher level of acuity simply because their provider’s office was closed. Nurse Triage provides access to clinicians, facilities and comprehensive triage care. It ensures an integrated care approach and often leads to internal referrals. Nurse Triage helps organizations better utilize scarce resources at overcrowded EDs and increased demands for primary care providers. Many trendy readmission prevention programs currently being managed by telephone triage nurses are proving to be successful. Continuous care contributes to the bottom line in the current fee-for-value reimbursement system. There are numerous other examples that demonstrate the positive impacts an optimized Nurse Triage service can make on your organization. To best serve the needs of your patients and ensure your organization maintains its competitive edge, your leadership must view Nurse Triage as a necessity and not a luxury!
Nurse Triage services are being skillfully and compassionately performed by thousands of registered nurses across the country. There are several different models of care that can be customized to the needs, strengths and goals of your organization or practice setting. If you are uncertain of how to move forward – contact an expert for assistance. It will be an investment in your patients’ improved health and your organizations’ lucrative future.
Gina Tabone MSN, RNC-TNP
Director – Strategic Clinical Solutions, THMCC