Teaching residents to communicate: the use of a telephone triage system in an academic ambulatory clinic.
OBJECTIVE
This study evaluated the use of a telephone triage system in an academic primary care clinic and its impact on communication, patient management and satisfaction.


METHODS
A "telephone clinic" was created using a triage nurse to answer patients' calls to an academic primary care clinic, staffed by house staff physicians. Chart reviews were conducted of all medical records of patients who called and were referred to the telephone clinic during a six month period. A total of 1135 patient calls were monitored. Using a random selection process, 366 patient calls were studied and 42% of these patients were called back two weeks after the initial call and were interviewed.


RESULTS
Of the 336 calls, 68% of the calls were serious enough to be referred to a house staff physician. Symptom complaints accounted for 64% of the telephone calls; 4% of patients were sent to the emergency room or admitted to the hospital directly based on the information from the call. Telephone calls enhanced patients' access to specialty care consultative services and 14% of patients who called received a new medication prescription. Patients' satisfaction with the communication and the overall care provided by the "telephone clinic" was highly rated.


CONCLUSIONS
The telephone contact initiated by the patients resulted in expedited access for patients whose symptoms were serious enough to require immediate referral to the emergency room or direct hospital admission.


CONCLUSIONS
In a primary care practice, the telephone can be a major source of communication for practitioners, office staff and patients. The creation of a "telephone clinic" which utilizes nurses and house staff physicians trained and dedicated to telephone communication directly with patients resulted in more efficient management and greater satisfaction for patients.
Caralis
Panagiota
P
Department of Medicine, University of Miami Miller school of Medicine, Veterans Affairs Medical Center, 1201 NW 16 Street, Miami, FL 33125, USA. Panagiota.Caralis@va.gov
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003142:Communication; D005260:Female; D005431:Florida; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019114:Remote Consultation / Q000706:statistics & numerical data; D013689:Telephone; D014218:Triage / Q000379:methods / Q000706:statistics & numerical data*