Abstract
BackgroundQuality assessment and continuous quality feedback to the staff is crucial for safety and efficiency of teleconsultation and triage. This study evaluates whether it is feasible to use an already existing telephone triage protocol to assess the appropriateness of point-of-care and time-to-treat recommendations after teleconsultations.MethodsBased on electronic patient records, we retrospectively compared the point-of-care and time-to-treat recommendations of the paediatric telephone triage protocol with the actual recommendations of trained physicians for children with abdominal pain, following a teleconsultation.ResultsIn 59 of 96 cases (61%) these recommendations were congruent with the paediatric telephone protocol. Discrepancies were either of organizational nature, due to factors such as local referral policies or gatekeeping insurance models, or of medical origin, such as milder than usual symptoms or clear diagnosis of a minor ailment.ConclusionsA paediatric telephone triage protocol may be applicable in healthcare systems other than the one in which it has been developed, if triage rules are adapted to match the organisational aspects of the local healthcare system.
Highlights
Quality assessment and continuous quality feedback to the staff is crucial for safety and efficiency of teleconsultation and triage [12]
The present study indicates that physician triage recommendations are congruent to a widely accepted telephone triage protocol for the majority (61%) of teleconsultations in children with abdominal pain
One aspect that needs to be considered when interpreting the results of the present study is that the organization of the Swiss healthcare system differs from the system in the U.S.A. for which the paediatric telephone triage protocol was initially developed [18]
Summary
Quality assessment and continuous quality feedback to the staff is crucial for safety and efficiency of teleconsultation and triage. This study evaluates whether it is feasible to use an already existing telephone triage protocol to assess the appropriateness of point-of-care and time-to-treat recommendations after teleconsultations. Almost half of patients can manage their health problem themselves after teleconsultation, and do not need a face-to-face consultation [3]. In addition to reducing unnecessary physician or emergency room visits, one motive for teleconsultation services is to help identify patients with serious medical problems and ensure they receive timely and adequate care, from the appropriate type of health care provider [4-7]. Health care professionals doing teleconsultation and triage are largely limited to medical history taking, without access to other diagnostic tools.
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