Development and implementation of a telephone triage curriculum for neurology residents (P3-2.005)

Abstract

<h3>Objective:</h3> Build a curriculum to support and improve neurology resident’s telephone triage skills of a patient emergency response line. <h3>Background:</h3> Many neurology trainees answer patient questions over the telephone while on call with minimal training or experience. Other non-neurology residencies have published quality improvement studies on trainee specific training on telephone triage skills. Not all institutions have imbedded training for residents on telephone triage skills. <h3>Design/Methods:</h3> Two months of pages routed through the pager response line were collected at an academic institution. A list of neurological complaints was created based upon the text of the page. Residents completed a pre-intervention survey of confidence level for management telephone triage. Based upon aggregated data of common neurologic complaints, a 1-hour lecture was given and triage flowsheets were developed to train residents on appropriate over-the-phone management of common neurological complaints. A post-intervention self-evaluation survey is planned for one month after the flowsheets are distributed to the residents. <h3>Results:</h3> The most common neurological complaints from patients using the pager response line were breakthrough seizure, persistent or worsening headache, a new neurological symptom, or worsening functional decline (46% of pages). Other common indications for calls included concern for a medication side effect or request for medication refills (35% of pages). For the pre-intervention survey, the majority of the residents (80%) responded as “not at all confident” to “somewhat confident” in their response to “How confident are you with answering pager response line pages independently?”. <h3>Conclusions:</h3> Majority of residents were not confident in providing the telephone triage service for our departmental after-hours pager response line. This exemplifies the need for more specific neurological telephone triage training for residents providing this service. A curriculum has been developed and is currently being implemented based upon the most common neurological complaints found during our study period. Post training survey will be administered November 2022. <b>Disclosure:</b> Dr. Eckenstein has nothing to disclose. Dr. Wold has nothing to disclose.