Emergency Department Attendance after Telephone Triage: A Population‐Based Data Linkage Study

Abstract

This large population-based data linkage study provides precise estimates of ED attendance following calls to a telephone triage service and details the predictors of ED attendance. Patients who attend an ED compliant with a healthdirect helpline disposition are significantly less likely than the general ED population to receive the lowest urgency triage category on arrival.

Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

“…Taking a broad view of TTASs' influence, from a health system perspective, is fundamental . Patients attending services inappropriate to their need results in poorer health outcomes, through inefficiencies, overcrowding, frustrations, and complaints—from staffs, patients, and families .…”

“…Comparing the impact and outcomes is fraught, as many studies are dated; sparse; variable for time periods; reflect different health systems; focus on differing service availability (during work hours or after hours); and, differ in triage models (nursing vs medical staff). Various studies on the topic have been conducted across a range of health systems and time periods though, including the United Kingdom, Canada, Switzerland, the United States, the Netherlands, Pakistan, Denmark, and Australia …”

“…Even so, TTAS have been assessed as providing safe, effective triage decisions and are positively regarded by users and providers. TTAS referrals were found appropriate with low triage acuity outcomes recorded, and the consultations receive positive reports for patient satisfaction, management of workload of general practitioners, and patient‐doctor satisfaction . An outright decision on the appropriateness of TTAS decisions is, however difficult.…”

“…In the context of an individual TTAS caller, determining the outcome involves tracking movement of care sought, recommended, and accessed. The driving force of this movement is the exchange between the caller and the triage health professional that aligns the caller's need and action to the TTAS recommendation . The exchange can alter the patient's care‐seeking behavior from the caller's initial inclination …”

Predictors of emergency department attendance following NHS 111 calls for children and young people: analysis of linked data

“…In light of increasing pressures on costs, health care systems are exploring approaches to labour substitution and workforce configuration. [1] For example telephone advice lines, are a common international approach [2] and used in the Netherlands [3], United States [4], Scotland [5], Australia, [6] and Norway [7]. One example from England is the main telephone-based service, NHS 111, which employs non-clinically trained staff to triage patients with urgent health care needs, usually outside of normal working hours.…”