Internal after-hours triage models provide control and cost-efficiency for smaller hospice and home health agencies. When a hospice agency manages its after-hours calls, case managers and clinicians often alternate on-call evenings and weekends, answering calls about scheduling, medications, and patient care. Triaging these calls requires skills that differ from bedside nursing. While communication is always essential for patient care, it becomes paramount when caring for patients over the phone. Consider these best practices if your agency manages your after-hours call internally.
See with your ears on after-hours triage
Active and empathic listening is the name of the game here. Unlike when the patient is in the room, phone-triage clinicians must use the information coming through the receiver to paint a picture of what is happening with the patient. Ask questions and repeat the answers to help the caller feel heard and ensure you address the chief complaint.
Get right to the point on the phone
The goal should be to have the chief complaint identified within the first minute of the call. The chief complaint is the primary reason the caller is seeking direction. Help the caller get to the point by asking pertinent questions and helping them to remain focused on the issue. There are often multiple factors the person on the other end of the line will want to address during a phone encounter, but the chief complaint will be the most severe or urgent issue identified by the caller.
Be patient with your patients
Remember that experienced clinicians do not equal experienced patients. While your clinicians may have heard from this patient or their family 10 times already, it is essential to understand that this is all new to them. Take the time to educate and hold the caller in mind. Often caretakers are doing shifts around their caring for their loved ones, so all the information does not make the complete journey from one caretaker to another. Or maybe the caretaker could not take in all the information the first time it was delivered. Patience in these interactions improves the patient experience and eases the burden on loved ones.
Protocols for after-hours triage
Your agency has protocols for everything, but phone triage deserves its own set of protocols, and all your on-call nurses must learn and abide by them. Understanding appropriateness for triage-addressable issues and when a home visit is warranted has ripple effects outside of the encounter itself. If the phone triage clinician can handle an encounter over the phone, it can result in more rapid relief for the patient or caregiver and relief of discomfort and anxiety. Additionally, with dedicated protocols and clear communication between clinicians, clinicians are afforded a modicum of peace, leading to less burnout. A nurse can end their shift knowing their patients are being cared for and that the triage nurse will call them to make a home visit only when necessary. With this assurance in place, they can preserve their energy for another time that might require a visit or get some rest to be their best nurse selves the next day.
Bernadette Smith is vice president of marketing for IntellaTriage. In her role, she is responsible for marketing strategies and the coordination of marketing operations. Before joining IntellaTriage, Smith led marketing and communications at QIRT (now McBee Associates) and was most recently managing director of the LTC100 Intelligence Group at Lincoln Healthcare Leadership.