Top 25 Adult and Pediatric Office-Hours Telehealth Triage Guidelines 2020 - 2022 (Copy)

Top 25 Adult and Pediatric Office-Hours Telehealth Triage Guidelines Used During Calendar Years 2020 - 2022

Authors:

Gary Marks 1

David A. Thompson 2

1 Asante Health Systems

2 Northwestern University, Northwestern University Feinberg School of Medicine

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 protocols (guidelines) provide a structured decision-support and documentation tool for triagers to use to standardize the telehealth encounter. Understanding which protocols 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 office-hours telehealth triage decision support system, were eligible for inclusion. Triage nurses select the most appropriate triage protocols based on the patient’s primary reason for call (main problem or symptom). Protocols selected were ranked for both pediatric and adult office-hours encounters.

Results: There were 4,420,797 office-hours patients triaged during the 3-year study period. Adult telehealth protocols were used in 1,968,732 (44.5%) and pediatric telehealth triage protocols were used in 2,452,065 (55.5%) of the encounters. Specific COVID-19 telehealth triage protocols were used in 12.5% of the adult encounters and in 8.7% of the pediatric encounters. Excluding COVID-19 protocols and two operational protocols (Information Only Call - No Triage and No Contact or Duplicate Call), the top 25 adult protocols were used in 56.9% of adult encounters and the top 50 adult protocols were used in 76.0%. With the same exclusions, the top 25 pediatric protocols were used in 63.1% of pediatric encounters and the top 50 pediatric protocols were used in 76.4%.

Conclusion: Reflecting the clinical needs and surge volumes of the COVID-19 pandemic, the COVID-19 telehealth protocols were the most commonly used office-hours protocols in calendar years 2020 through 2022. Excluding COVID-19 protocols and non-clinical operational protocols, the top 25 adult protocols were used in more than 50% of adult encounters and the top 25 pediatric protocols were used in just over 60% 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 Office-Hours Telehealth Triage Guidelines Used During Calendar Years 2020- 2022. March 31, 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 After-Hours Telehealth Triage Guidelines Used During Calendar Years 2020 – 2022. Abstract and Charts.