title: The impact of a nursing triage line on the use of emergency department services in a military hospital.
abstract: The purpose of this study was to evaluate the impact of nursing telephone triage on the appropriateness of emergency department (ED) use among 563 patients at a military hospital by comparing 286 ED patients referred by the Tel-a-Nurse Line (TAN) with 277 non-TAN-referred patients from October 2000 to November 2000. When controlling for confounding factors, TAN-referred patients had less appropriate ED use than non-TAN-referred patients, although this was not statistically significant (odds ratio = 0.87, p = 0.452). After excluding TAN patients with a primary clinic disposition but who were directed to the ED because no clinic appointments were available, TAN-referred patients had more appropriate referrals than non-TAN patients, although this was also not significant (odds ratio = 1.19, p = 0.401). TAN patients directed to the ED because of clinic appointment unavailability contributed significantly to inappropriate ED use with 62% having low acuity. This finding underscores the need to evaluate clinic availability for the TAN line and possibly for all patients as well.
authors.affiliation: Medical University of South Carolina, Department of Biometry and Epidemiology, Charleston, SC 29425, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Custer
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: O'Rourke
authors.forename: Mary
authors.initials: M
authors.lastname: Roddy
authors.forename: Rosemary
authors.initials: R
authors.lastname: King
authors.forename: Leticia
authors.initials: L
authors.lastname: Sprinkle
authors.forename: Eva
authors.initials: E
authors.lastname: Horne
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016529:Emergency Nursing; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D019114:Remote Consultation; D014218:Triage