Optimization of the triage nurse's time by decreasing time spent on non-nursing functions.

Abstract

293 Background: Triage nurses are an essential part of the multidisciplinary management of the oncology patient. Because of the nature of their role, they spend a significant amount of time performing non-nursing functions, resulting in a delay in patient care and decreased job satisfaction. This study will examine whether implementing a central phone triage system and commensurate process improvements in a large oncology practice will decrease the amount of time that the triage nurses spend on non-nursing functions. Methods: Nine triage nurses at our practice participated in a survey to obtain baseline data. The survey focused on data regarding the non-nursing issues that are encountered during the work day. We then developed a survey for the nurses to determine how much time per 8-hour work day, was spent on the identified non-nursing functions. A new telephone operator system was evaluated for suitability and then implemented. With the new system, the central operator answers all phone calls coming into the practice, and directs them to appropriate department via a messaging system, thus eliminating phone calls to the triage nurses’ direct extensions. Two months after the implementation of this new system, we recollected data to measure the time spent on the previously identified non-nursing functions. A job satisfaction survey was collected pre- and post-study. Results: The initial data collected showed that triage nurses spent approximately 60 minutes per day on non-nursing functions. These functions included the following: the amount of time listening to and taking off patient messages, pre-cert issues, order clarifications and social work issues. The data collected after implementing a new telephone system showed that this time dropped to approximately 12 minutes per day, a 78% reduction in non-nursing calls received by nurses. Additionally, there was a 7% increase in the triage nurse job satisfaction. Conclusions: After implementing a new telephone operator system, the nurses at this large oncology practice were able to better optimize their time taking care of patient related nursing functions. This improved their work flow, increased their time performing direct patient care related functions, and increased their overall job satisfaction. During this process, we also learned the importance of taking triage nurses input to improve their job function. Further research is recommended to better define the role of the phone triage nurse with the multidisciplinary care team of complex hematology/oncology patients.