A retrospective quality assessment of the 7119 call triage system in Tokyo – telephone triage for non-ambulance cases

Abstract

Summary We assessed the accuracy of telephone triage at the 7119 telephone consultation centre in Tokyo. We evaluated walk-in patients at primary care facilities in a clinic or hospital. Nurses asked all patients calling 7119 to join the study and gave them a specific identification number (ID no) at the end of the telephone consultation. The outcome of the consultation was defined as discharge to home (home), admittance to hospital (hospitalization), referral, or transfer to another hospital. After matching consultation records and patient data by ID no, emergency medical physicians reviewed the protocol for problems. During the study, consultation nurses issued an ID no in 17,141 cases, and hospitals and clinics sent back the data on 1205 patients. Among these patients, 1119 cases (93%) were home, 59 cases (5%) were hospitalization, 18 cases (2%) were referral and 9 cases (1%) were transfer. Of the 86 cases which had an outcome of hospitalization, referral or transfer, there were 56 cases with matched patient data. Among these 56 cases, review showed no significant problems with 37 cases. However, there were 11 cases with patient refusal to comply with the triage recommendation, 4 cases with 7119 staff education problems and 4 cases with problems with the protocol itself. We were able to evaluate the 7119 telephone triage system in Tokyo. The study identified three types of problems with the triage process: refusal of telephone triage recommendations, problems with staff education and problems with the protocol itself.

The relationship between seasonal influenza and telephone triage for fever: A population-based study in Osaka, Japan

“…As with the telephone triage service in Tokyo, that in Osaka prefecture is also a public service [20] and can be freely used by anyone. A triage nurse at the service uses software with a protocol for telephone triage in Japan and determines the urgency of the client.…”

Pre- and Post-home Visit Behaviors using an after-hours House Call (AHHC) Medical Services: A Questionnaire-based Survey in Tokyo, Japan

“…The telephone triage involves a patient calling an emergency telephone consultation service and being classi ed into one of ve categories (red, orange, yellow, green, or white), based on symptom acuity. The red category implies the presence of a life-threatening condition or one that is likely to worsen or change rapidly; orange re ects a condition requiring immediate hospital attendance, as the symptom(s) may worsen over time; yellow requires a hospital visit as the symptom(s) may worsen over time; green does not have symptoms listed in the previous categories but requires a hospital visit; and white re ects symptoms that do not require a hospital visit [9].…”

“…In Japan, to reduce non-urgent ED visits and ambulance use, telephone consultation services and educational activities to promote appropriate ambulance use were introduced in 2007 [9]; regardless, the number of ambulance calls and the duration of transportation have continued to increase [10]. As part of Japan's universal health care system, patients with emergency health problems can call an ambulance free of charge, and 97.9% of callers receive ambulance transportation to emergency hospitals [11].…”

Changes in The Use of After-Hour House-Call Medical Services For Fever or Common Cold Symptoms During The COVID-19 Pandemic in Tokyo, Japan: A Descriptive Study

“…A well-used telephone triage in Japan is as follows; when a patient calls an emergency telephone consultation service, an operator classi es the patient into one of ve categories (red, orange, yellow, green, or blue) based on acuity. The action for consultation is as follows: red: call an ambulance and deliver the patient to a secondary or tertiary emergency hospital; orange: provide the patient with information about a nearby secondary emergency hospital; yellow and green: provide the patient with information about nearby clinics or a primary hospital; and blue: provide the patient with advice for home observation [10].…”