A triage model that has each caller speak to a registered nurse first, instead of leaving messages with an operator and waiting for a nurse to work through the queue and call back. Though this arrangement uses more nurse time than models that first screen calls with an agent, it expedites the clinical assessment process and removes an unnecessary handoff.
Also called: direct-to-nurse triage, live nurse triage
Quick facts chips: Function: Clinical call handling | Domain: Triage models | Used by: Health systems, practices, health plans | Related terms: nurse triage, medical answering service
How does nurse-first triage differ from other models?
- Nurse-first: Nurses answer each call live.
- Message-first: An operator takes a message from the caller and a nurse calls back.
- Screened routing: Trained non-clinical staff handle the routine calls and route any calls about symptoms to nurses.
What are the benefits?
- Faster clinical assessment: Patients are able to speak to a nurse right away and have their symptoms evaluated.
- No callback delay: Patients don’t have to wait between talking to an operator or agent and receiving a callback from a nurse, saving valuable time.
- Fewer abandoned calls: Fewer patients give up and hang up the call before they can speak to a nurse.
What are the tradeoffs?
- Higher cost per call: Since a registered nurse is taking calls, the higher labor cost makes each call more expensive.
- Nurses fielding non-clinical questions: With nurse-first triage, nurses are the front line, which means that many of the calls they receive are likely to be non-clinical questions that don’t require their level of expertise.
These tradeoffs are why many medical groups choose to pair triage with a non-clinical front line for more routine calls.
When does nurse-first triage fit best?
- High symptom-call volume: If a medical group receives a lot of calls asking questions about symptoms or other clinical concerns, a nurse-first model makes a lot of sense.
- Pediatric practices: Pediatric medicine is a perfect storm for nurse-first triage. Infants and kids aren’t fully able to articulate their symptoms, parents and guardians may be anxious for guidance, and the fragility of small children means that answers can range from watching the problem at home to an immediate trip to the ER. Having a nurse on the front line allows these callers to get immediate answers in a confusing and potentially tense situation.
- After-hours coverage: When patients call after hours, that usually means that the problem couldn’t wait until morning. A callback delay during this timeframe carries more risk than an on-hours call.
FAQs
Is nurse-first triage more expensive?
Yes, on a per-call basis. A registered nurse has a higher labor cost than non-clinical staff. If every call is answered by a nurse instead of a front-desk or call center agent, then each call is more expensive.
Can nurse-first and a non-clinical front line be combined?
Yes, and hybrid models like this are common. In hybrid models, the non-clinical team can handle the calls that don’t require clinical expertise, while nurses handle symptom and health-related calls. With the right routing rules, a hybrid model triage can be fairly effective.
