How Do I Stop Routine Patient Calls Going to Nurse Triage?

When no one else is set up to handle routine non-clinical calls, the calls can often end up in the hands of nurse triage, who more than likely have more pressing matters to attend to. To fix this, a first-line team, following clinician-approved routing rules, can effectively resolve callers’ non-clinical questions, only escalating to nurse triage for the calls that require a nurse’s trained clinical judgement.

What are the hidden cost of routine calls in triage?

An unnecessary load of routine calls will easily clog up the nurse triage lines and get in the way of care for patients who have more serious concerns requiring a nurse’s help. Any time a nurse is the one tasked with answering a question about scheduling or billing, that’s potential for a patient with active symptoms having to wait longer to get called back, while also contributing to burnout for nurses who are forced to burn the candle at both ends. Additionally, a nurse answering a routine question on the phone means spending clinical wages on work that doesn’t require that skillset, driving up the cost of labor per call.

How to sort clinical from non-clinical calls?

Audit what triage is actually handling

Take a close look at a full week of triage calls and categorize each one with a tag for the reason for calling. This data will provide you with a quantitative understanding of the types of calls you receive and how many of them actually need help from a nurse.

Typical routine call types

The most common examples of routine calls to healthcare clinics include:

• • Scheduling
  • Prescription refills
  • Test results
  • Requests for forms
  • Billing
  • Directions to the clinic

These topics do not require the expertise of a nurse.

How to build a safe first line?

Routing rules owned by clinical leadership

Your clinic’s leadership needs to judge where the line between “routine” and “clinical” lies, and therefore which calls stay with a first-line team and which require a nurse. These rules should be regularly reviewed by clinical leaders to ensure that they continue to facilitate effective call routing, efficient use of nurses’ time, and a positive patient experience.

Escalate whenever there’s doubt

If a call mentions anything about symptoms or discusses anything that the first-line team is unsure about, then the call should be escalated to a nurse. First-line staff should never give clinical advice, so when in doubt, escalate the call.

Clean handoffs to nurses

Whenever a call is escalated, the call should arrive with the patient’s details along with their reason for calling to ensure that nurses have the context they need to pick up the conversation where it left off.

Keeping it consistent across sites

Multi-site clinics need consistency of experience, so it’s important that each site is working with the same routing rules. This ensures that each location of your clinic escalates in the same manner and under the same circumstances, providing patients with the same experience and level of security no matter which location they call.

How do I measure the change in escalation procedures?

To track how well the change in escalation procedures is going, there are 3 metrics that paint an informative picture:

• Share of triage calls that are non-clinical: What percentage of calls that reach nurse triage are non-clinical in nature? If things are going well, this should be going down.
• Nurse callback time: How long does it take for patients to hear back from a nurse if their first call went unanswered or unresolved? If that timeframe gets shorter, you’re on the right track.
• Escalation accuracy: Are first-line staff only handling routine calls and escalating any clinical topics? Are nurses only receiving clinical calls?

Where to start first?

To begin the process of proper call escalation in your clinic, get started with a one-week audit of all the reasons patients call in. This will help build the correct idea of what types of calls you tend to receive and when, which gives you a better picture of where a first-line team can take over, and how many clinical calls you’ll need to escalate.

Do you need a hand auditing your calls and building smarter call routing rules for your clinic? Get in touch with ROI CX Solutions today to see how we make that a smooth process!

Schedule a conversation with our team.