Top 25 Adult and Pediatric After-Hours Telehealth Triage Guidelines Used During Calendar Years 2020 - 2022
Authors:
David A. Thompson 1
Gary Marks 2
1 Northwestern University, Northwestern University Feinberg School of Medicine
2 Asante Health Systems
Background: The goal of the telehealth triage process is to sort patients to the most appropriate level of medical care (disposition) based upon the acuity and severity of their symptoms (i.e., that best meets their medical needs). Telehealth triage guidelines (protocols) provide a structured decision-support and documentation tool for triagers to use to standardize the telehealth encounter. Understanding which guidelines are used most commonly is useful in identifying high volume areas to best target for quality improvement activities and to focus on for triage nurse onboarding and continuing education.
Methods: All patients triaged (saved encounters) during calendar years 2020 through 2022, using a single nationally available browser-based after-hours telehealth triage decision support system, were eligible for inclusion. Triage nurses select the most appropriate triage guidelines based on the patient’s primary reason for call (main problem or symptom). Guidelines selected were ranked for both pediatric and adult encounters.
Results: There were 3,289,976 patients triaged during the 3-year study period. Adult telehealth guidelines were used in 2,131,111 (64.8%) and pediatric telehealth triage guidelines were used in 1,158,865 (35.2%) of the encounters. Specific COVID-19 telehealth triage guidelines were used in 14.6% of the adult encounters and in 8.2% of the pediatric encounters. Excluding COVID-19 guidelines and three operational guidelines (Information Only Call - No Triage, No Contact or Duplicate Call, PCP Call - No Triage), the top 25 adult guidelines were used in 46.8% of adult encounters and the top 50 adult guidelines were used in 65.5%. With the same exclusions, the top 25 pediatric guidelines were used in 60.6% of pediatric encounters and the top 50 pediatric guidelines were used in 75.6%.
Conclusion: Reflecting the clinical needs and surge volumes of the COVID-19 pandemic, the COVID-19 telehealth guidelines were the most commonly used guidelines in calendar years 2020 through 2022. Excluding COVID-19 guidelines and non-clinical operational guidelines, the top 25 adult guidelines were used in almost half of adult encounters and the top 25 pediatric guidelines were used in just over 3 of 5 pediatric encounters.
Attribution: The authors are grateful to ClearTriage (www.cleartriage.com) for providing the data used in this article. ClearTriage is a web-based clinical decision support system that licenses the Schmitt-Thompson Telehealth Triage Guidelines (www.stcc-triage.com).
Citation: Thompson DA, Marks GA. Top 25 Adult and Pediatric After-Hours Telehealth Triage Guidelines Used During Calendar Years 2020- 2022. March 22, 2023.
Related References
Thompson DA. Medical Call Center Benchmarking Report: 2004 to 2016. An analysis of 6.5 million triage calls from 16 medical call centers. Full report available to participating call centers. 2017. Summary Report and Charts.
Marks GA, Thompson DA. Top 25 Adult and Pediatric Office-Hours Telehealth Triage Guidelines Used During Calendar Years 2020 – 2022. Abstract and Charts.