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Triage is Good Medicine. Author: Erich W Mack LDO, ABOC-AC, NCLC. Abstract.
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Triage is Good Medicine Author: Erich W Mack LDO, ABOC-AC, NCLC
Abstract A sometimes overlooked and critically important process to the optometric practice patient care is telephone triage. Most practices have multiple people answer patient phone lines, whether its their main job duty or not, and this can leave opportunity for patient care to fail. Giving proper medical need recommendations is a responsibility to all employees that have access to the phones. Good triage equates to good medicine and reduces practice liability.
What You Will Learn • What is triage and why it is important • How to create your own triage chart • How to create a triage phone algorithm • How to deploy a successful triage program in your practice
Ocular Distress Phone Calls Ummm... HELP, what should I do?
Handle Emergencies Using Triage We don't have open appointments. What should I do?
Utilize Staff on Hand if Possible Reception SALES Pretest Optical Management And NOW TRIAGE
Its a Matter of Good Medicine What happened? When did it happen? How did it happen?
Does Your Office Have a Triage Protocol? ? Triage protocols OR
Don't Put Yourself in a Liability Situation No Triage Plan Lawsuit Lost $$$$$$ and potential losing your business and license
Physician Insurers Association of America $12,400,000!
Infamous Lawsuit • Triage was performed • Triage protocol did not accurately assess patients severity • Infant lost hands and feet as a result • Family was awarded $45,000,000
Another Lawsuit Example • Elderly man wanted to see his doctor • Receptionist said the doctor was on vacation • Man wasn't seen for a couple weeks later • When the initial call was made he was having a mild heart attack • He suffered further heart damage due to the delay
Should He Be Seen Or Not? It's not that painful. I don't think I should come in. We are very busy so call back if it gets worse.
Don't Let This Happen My whole family is infected! Why didn't you let me see the doctor!
Detached Retina's are Emergencies If it doesn't hurt its not An emergency. Call Us if it gets worse. My eye is acting weird
Don't Let This Happen I'm blind in my eye. If only I could have been seen sooner.
Creating a Triage Protocol Triage Urgency Chart
Make Your Own Office Triage Chart Let's talk triage
Ask the Right Questions ALGORITHM If This Then That process will lead you to proper recommendations
Know the Symptoms and Urgency 911 Triage 1-4 Hours 24 Hours
Document Everything! Calm and Caring Take notes of phone interaction
Step 1 – Phone Triage What, where, how...
Step 2-5 – Phone Triage History Symptoms
Step 6 – Phone Triage Let me repeat back to you so we are clear
Step 7 and 8 – Phone Triage Triage Urgency Chart ASSESSMENT! DOCUMENTATION!
Some Patient Will Call With Non-Ocular Emergencies I just feel and I think my leg Is broken and my Eyes are sore. What should I do? Call 911
Triage Implementation in the Office Triage Urgency Chart Triage Q's Staff Training is Important
Post in a Conspicuous Area Good thing I have my chart and Question algorithm right here
Triage Equals Good Medicine Triage Urgency Chart Triage Questions Documentation Caring GOOD MEDICINE!
Thank You! REFERENCES • Ganske G. Weekly report from Representative Greg Ganske (4-IA). 25 Jan 1999 • Coons C Kathryn Telephone Triage 2000 American College of Physicians • Grasso Jillian, Long Janet, McCulloch Joanna, Moore Cheryl Eye Education for Emergency Clinicians Dec 2008 • Graves D. Distance Learning Course: Triaging Ocular Emergencies 2010 • Katz Harvey. Patient Safety and Telephone Medicine Some Lessons from Closed Claim Case Review • Wheeler SQ. Anecdote related to S. Wheeler during conference presentation of “Telephone Triage: Essentials for Expert Practice,” at the Contemporary Forums Conference, Dublin, California. 1999