Administration and Practice Management| November 01 2003 Nurses’ and Pediatricians’ Telephone Triage Comparable AAP Grand Rounds (2003) 10 (5): 57–58. https://doi.org/10.1542/gr.10-5-57 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Nurses’ and Pediatricians’ Telephone Triage Comparable. AAP Grand Rounds November 2003; 10 (5): 57–58. https://doi.org/10.1542/gr.10-5-57 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: telephone triage Source: Lee TJ, Baraff, LJ, Guzy, J, et al. Does telephone triage delay significant medical treatment? Advice nurse service versus on-call pediatricians. Arch Pediatr Adolesc Med. 2003;157: 635–641. Pediatricians have become increasingly reliant on dedicated telephone triage services staffed by nurses in order to provide patient advice and control patient demand for medical care. These telephone triage services are thought to reduce physician workloads and potentially reduce healthcare costs. There is little research evaluating the quality of telephone triage services provided by nurses. This study by investigators at the University of California Los Angeles and McKesson Health Solutions in Broomfield, Colorado, compared the quality of medical advice from on-call physicians in Denver, with that of nurses using the Pediatric Triage and Advice System (PTAS) clinical decision-making algorithms in a call center at Children’s Hospital, Denver. The study assessed the quality of advice by comparing the proportion of callers who sought medical medical care despite being advised that it was not necessary, and the proportion of those who, nonetheless, sought care and actually received significant care. Significant care included hospitalization, parenteral antibiotics, intravenous fluids, burn care, fracture or joint reduction, foreign body removal, or antibiotic prescription. Participants belonged to a university general pediatric faculty practice, a population that was predominantly well-educated, white, and insured. Minorities accounted for about 20% of practice families and Medicaid or Medicare recipients accounted for 2%. After excluding calls regarding children requiring true emergency care (ie, unconscious, not breathing, respiratory distress), 2,753 calls needing medical advice were deemed eligible for the study. Of these, 1,184 parent callers volunteered to participate in the study and were randomly divided into 2 groups by the answering service operators: 566 had their calls referred to the on-call pediatrician group and 616 to the nurse advice group. There were no significant differences in age (P=.67), P gender (P=.86), ethnic group, insurance status, time of call, or type of complaints between the 2 groups (P=.52). Callers were divided into 3 groups based upon the kinds of care recommended during the phone call: immediate emergency or urgent care, office care within 72 hours, and self-care. Physicians and advice nurses recommended similar proportions of callers to each of the 3 categories of care. After 72–96 hours, all participants were contacted to determine the care the child actually received within 72 hours of the initial telephone call. Nineteen percent of parents in the nurse call group and 19.9% of parents in the physician call group (difference 0.9%; 95% CI, -3.8 to 5.5) sought care beyond that originally recommended. Of these unadvised self-referrals, 4.3% of nurse calls and 4.2% of physician calls resulted in significant medical care decisions (difference 0.1%; 95% CI, −2.5 to 2.3). Most of these children required antibiotics. The authors conclude that nurse triage did not cause any greater delay in care than phone advice given by physicians. As telephone care increases within pediatric practice, more pediatricians are utilizing nurse call centers for triage... You do not currently have access to this content.