Remote nurse triage and standardization of clinical pathway utilization.

Abstract

574 Background: In March of 2022, Texas Oncology (community oncology practice) initiated a state-wide rollout for Remote Nurse Triage. This program implemented and standardized the utilization of Clinical Pathways within the Navigating Care system with a goal to decrease time to patient first call back, increase first touch resolution for patient-initiated contact, and increase patient satisfaction related to patient-initiated communication resolution. Methods: To determine an appropriate plan of action, a needs assessment was conducted to evaluate current pathway utilization, call volumes and patient satisfaction. Based on the findings of this assessment, triage nurses were trained to resolve incidents using standardized care pathways and standing orders within the Navigating Care System. This implementation was monitored on a weekly basis with metrics from Navigating Care and the Relatient dashboard and compared to the 12-month baseline data for 2 beta sites. Results: In the 12-month pilot, standardized pathway utilization increased from 1% pre-pilot to 78% post-pilot for clinical symptom management calls. With standardized pathways and better first touch resolution clinical calls decreased 8% overall from 4,302/month to 3,987/month while patient volumes (billable visits) increased 25%. Patient satisfaction scores, in relation to their phone experience and needs resolution, went up to 4.5/5 from 3.9/5. Symptom management resolution times also trended down since beginning the pilot. Conclusions: Standardizing the usage of clinical pathways by virtual triage nurses reduced clinical call volumes despite a positive growth in the number of billable visits at the pilot sites. This increase in pathway utilization also led to decreased time for symptom management resolution. Additionally, these measures resulted in an increased patient satisfaction related to patient-initiated communication.