Risks of Telephone Triage

There are risks associated with telephone triage, just as with every other area of health care. Quality health care is always the end product of an involved process. A breakdown in any step along the way will produce an increased risk to the quality of the care delivered and the care received by the patient. The following interventions may be used to avoid unnecessary risks:


Ways to Avoid

Wrong assessment, decision, or advice

ALWAYS follow established protocol.

  • Never assume, never guess, never compromise; always work the call to the utmost of certainty.
Incomplete history

Nurse should ask open-ended questions whenever possible and offer suggestions that might spur the caller's memory.

  • Ex: What type of past medical history do you have, such as heart disease, liver disease, seizures, asthma, immune problems, etc.?
  • Ex: What types of injuries have you been treated for in the past?
Incomplete assessment

Always address each possible system involved, including the social situation surrounding the caller.

Follow guidelines carefully.

Perform a focused assessment of the complaint.

Restate questions if the caller's answer was ambiguous.

Caller mistrust of telephone program

Nurse should establish an excellent rapport with the caller immediately in the conversation.

  • Remember that the caller is stressed, may have poor communication skills, or may be very frightened.

The caller must know that their health care is of utmost importance to the telephone nurse.

Always ask the caller if they are comfortable with the topics discussed and the advice given.

Caller misunderstanding

Ask caller to repeat instruction when given, and suggest they write them down.

Ask for questions.

Poor documentation

Document precisely.

  • This is necessary if future readers are to understand exactly the dynamics of the call.
Instant Feedback:
To save valuable time, the telephone triage nurse should ask questions with "yes" or "no" answers as much as possible.

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