Design and Implementation of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

Spaulding, Alicen B; Radi, Deborah; MacLeod, Heather; Lynfield, Ruth; Larson, Michelle; Hyduke, Terri; Dehnel, Peter J.; Acomb, Craig; DeVries, Aaron

doi:10.1177/003335491212700509

Cited by 22 publications

(55 citation statements)

References 13 publications

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“…Of these 3,691 (26%) were information only/non-flu-related/duplicate calls, 3,799 (27%) were transferred to a partner NTL, and 6,468 (46%) had the nurse protocol administered by the contract NTL of which 374 were prescribed oseltamivir by the NTL [13]. Of the 6,468 calls managed by the contract NTL, 38 calls occurred in March and were ineligible to be included as randomization for the survey occurred in March prior to the completion of MN FluLine operations, leaving 6,430 eligible to be included in the survey (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Specific details of the MN FluLine intervention have been previously presented [13]. In brief, all healthcare plans (organizations that provide healthcare insurance coverage) and large healthcare delivery organizations (organizations that directly provide healthcare using clinics or hospitals) with NTLs serving Minnesota collaborated to form a unified triage system with a single toll-free number serving the MN population (5.3 million) and agreed to operate in a coordinated fashion.…”

Section: Methodsmentioning

confidence: 99%

“…The nurse contacted a pharmacy of the callers’ choice and prescribed oseltamivir per protocol. Minnesota state antiviral supplies were distributed to pharmacies throughout Minnesota and were accessed if the patient was underinsured, uninsured, or there was a local disruption of oseltamivir supply [13]. Costs were assessed from the perspective of public health implementation and incurred cost by MDH for operating the MN FluLine were calculated based on call numbers.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously described how the MN FluLine reached over 27,391 callers preventing up to an estimated 10,998 in-person healthcare contacts [13]. However to date there has not been an assessment of how NTLs were perceived by the callers nor an assessment of the costs associated with such programs.…”

Section: Introductionmentioning

confidence: 99%

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Satisfaction and Public Health Cost of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

Spaulding

Radi

MacLeod³

et al. 2013

PLoS ONE

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BackgroundThe 2009 H1N1 pandemic strained healthcare systems. There was a need for supportive services, rapid antiviral access, and minimization of unnecessary healthcare contacts particularly face-to-face interactions. In response, the Minnesota Department of Health (MDH) launched a telephone-based nurse triage line (NTL) called the Minnesota FluLine coordinating all major MN healthcare systems with NTLs to form a single toll-free number triage service. Callers were evaluated for symptoms of influenza-like illness (ILI) and were prescribed an antiviral if indicated, using nurse administered protocols.MethodsTo determine caller outcomes, associated healthcare seeking, and satisfaction a telephone survey of Minnesota FluLine callers was conducted using a 5% random sample of those who completed the protocol and those who did not.ResultsOf 6,122 callers with ILI who began the nurse protocol administered by the contract NTL, 1,221 people were contacted for the survey and 325 agreed to participate; response rate was 26%. Of those who completed the nurse protocol 73% said they would have sought healthcare without the Minnesota FluLine, 89% reported the service was moderately or very helpful, and 91% reported being satisfied or very satisfied. Of those not completing the protocol, 50% reported the service was moderately or very helpful and 50% reported being satisfied or very satisfied. 72% of qualitative responses to open-ended questions were positive regarding the MN FluLine. Cost to MDH for operating the Minnesota FluLine service was $331,226 to service 27,391 callers ($12.09/call).DiscussionThe Minnesota FluLine diverted patients with mild ILI symptoms away from acute care visits at low cost and had a high rate of satisfaction among callers. Early intervention likely prevented morbidity and possibly additional cases. NTLs are powerful and flexible tools for pandemic response and should be considered as an important tool for future emergency responses.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Satisfaction and Public Health Cost of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

Spaulding

Radi

MacLeod³

et al. 2013

PLoS ONE

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“…23,24 An important theme voiced by participants across all sessions relates to using several simultaneous strategies-a ''layered'' approach-to facilitate access to antivirals. Participants recognized that no single strategy can solve the full range of problems that might emerge during a severe pandemic.…”

Section: Access To Antivirals In An Influenza Pandemicmentioning

confidence: 99%

Facilitating Access to Antiviral Medications and Information During an Influenza Pandemic: Engaging with the Public on Possible New Strategies

FainBarbara¹,

KooninLisa²,

Stoto³

et al. 2014

Biosecurity and Bioterrorism: Biodefense Strategy, Practice, an

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Antiviral medications can decrease the severity and duration of influenza, but they are most effective if started within 48 hours of the onset of symptoms. In a severe influenza pandemic, normal channels of obtaining prescriptions and medications could become overwhelmed. To assess public perception of the acceptability and feasibility of alternative strategies for prescribing, distributing, and dispensing antivirals and disseminating information about influenza and its treatment, the Institute of Medicine, with technical assistance from the Centers for Disease Control and Prevention (CDC), convened public engagement events in 3 demographically and geographically diverse communities: Fort Benton, MT; Chattanooga, TN; and Los Angeles, CA. Participants were introduced to the issues associated with pandemic influenza and the challenges of ensuring timely public access to information and medications. They then discussed the advantages and disadvantages of 5 alternative strategies currently being considered by the CDC and its partners. Participants at all 3 venues expressed high levels of acceptance for each of the proposed strategies and contributed useful ideas to support their implementation. This article discusses the key findings from these sessions.

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A multidisciplinary telemedicine model for management of coronavirus disease 2019 (COVID-19) in obstetrical patients

Reforma

Duffy

Collier

et al. 2020

American Journal of Obstetrics & Gynecology MFM

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BACKGROUND: The COVID-19 pandemic caused by the SARS-CoV-2 has increased the demand for inpatient healthcare resources; however, approximately 80% of patients with COVID-19 have a mild clinical presentation and can be managed at home. OBJECTIVE: This study aimed to describe the feasibility and clinical and process outcomes associated with a multidisciplinary telemedicine surveillance model to triage and manage obstetrical patients with known exposures and symptoms of COVID-19. STUDY DESIGN: We implemented a multidisciplinary telemedicine surveillance model with obstetrical physicians and nurses to standardize ambulatory care for obstetrical patients with confirmed or suspected COVID-19 based on the symptoms or exposures at an urban academic tertiary care center with multiple hospital-affiliated and community-based practices. All pregnant or postpartum patients with COVID-19 symptoms, exposures, or hospitalization were eligible for inclusion in the program. Patients were assessed by means of regular nursing phone calls and were managed according to illness severity. Patient characteristics and clinical and process outcomes were abstracted from the electronic medical record. RESULTS: A total of 135 patients were enrolled in the multidisciplinary telemedicine model from March 17 to April 19, 2020, of whom 130 were pregnant and 5 were recently postpartum. In this study, 116 of 135 patients (86%) were managed solely in the outpatient setting and did not require an in-person evaluation; 9 patients were ultimately admitted after ambulatory or urgent evaluations, and 10 patients were observed after hospital discharge. Although only 50% of the patients were tested secondary to limitations in ambulatory testing, 1 in 3 of those patients received positive results for SARS-CoV-2 (N¼22, 16% of entire cohort). Patients were enrolled in the telemedicine model for a median of 7 days (interquartile range, 4e8) and averaged 1 phone call daily, resulting in 891 nursing calls and 20 physician calls over 1 month. CONCLUSION: A multidisciplinary telemedicine surveillance model for outpatient management of obstetrical patients with COVID-19 symptoms and exposures is feasible and resulted in rates of ambulatory management similar to those seen in nonpregnant patients. A centralized model for telemedicine surveillance of obstetrical patients with COVID-19 symptoms may preserve inpatient resources and prevent avoidable staff and patient exposures, particularly in centers with multiple ambulatory practice settings.

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Design and Implementation of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

Cited by 22 publications

References 13 publications

Satisfaction and Public Health Cost of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

Satisfaction and Public Health Cost of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza

Facilitating Access to Antiviral Medications and Information During an Influenza Pandemic: Engaging with the Public on Possible New Strategies

A multidisciplinary telemedicine model for management of coronavirus disease 2019 (COVID-19) in obstetrical patients

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