Telephone Triage Supports Primary Care Clinics
Telephone triage is vital to the Rush strategic plan, which includes the pillars of health equity, growth and reach, people, quality and safety, and financial strength. It has been shown to improve the patient’s experience by providing timely and accurate care direction. Additional benefits of the nurse triage role include enhancing population health by reducing barriers and connecting patients to accessible medical care, reducing costs by preventing unnecessary healthcare utilization, optimizing resource allocation and work efficiency and reducing clinician burnout.
The Rush University Medical Group Access Center telephone triage registered nurses (RNs) support six primary care clinics. The team assesses patient symptoms, determines patient acuity and facilitates transitions to the appropriate level of care. Telephone triage protocols utilize evidence-based standards and the RN’s clinical expertise to guide decision-making. Based on the RN’s determination of the patient's level of urgency to receive medical care, the essential next step is linking the patient with the next level of care.
After closely reviewing the 2023 access center data, opportunities were identified to streamline the 57 nurse-driven protocols. Over half of all patients triaged by the Access Center led to same-day disposition in the primary clinics, more than 300 patients per month. Many of these patients met the criteria to access provider care via urgent care or telehealth appointments. In addition to consolidating the evidenced-based protocols to 14 patient dispositions, linking patients to same-day virtual appointments was added.
The Access Center performed a pilot to evaluate the updated protocols during the summer of 2024. The findings revealed more appropriate patient disposition and care timeliness, including increased telehealth appointments and improved River North urgent care clinic utilization. Presenting the findings to the Rush University Medical Group Quality Committee, the Access Center received permission to move beyond a pilot phase and into permanent implementation. In addition, this work will be expanded across the system.