Telephone triage: sidestepping the pitfalls

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Telephone triage is the process by which a health care provider communicates with a client via the telephone and, thereby, assesses the presenting concerns, develops a working diagnosis, and determines a suitable plan of management. Determination of the seriousness of the situation will dictate whether a client can be cared for at a distance or whether a more comprehensive in-person evaluation is in order.The process of telephone triage is fraught with potential problems, including difficulty in establishing a reliable database, environmental distractions, cost concerns, liability issues, and, frequently, inadequate documentation. This article will describe an approach to these concerns by discussing the use of appropriate communication techniques, the development of a working diagnosis, the establishment of a plan of intervention, and the appropriate documentation of care. Such steps will go far toward diminishing the growing legal threats that arise to midwives who utilize this technology to render care to their patients.
As the number of telephone calls increases and the costs of pediatric call centers rise, many pediatricians are considering developing their own after-hours call centers within their practices. The author describes how to establish such a system.
The authors review the costs of clinical telephone care in pediatric practice and discuss strategies for improving quality and cost-effectiveness.
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