The appropriateness of, and compliance with, telephone triage decisions: a systematic review and narrative synthesis.
OBJECTIVE
This paper is a report of the synthesis of evidence on the appropriateness of, and compliance with, telephone triage decisions.


BACKGROUND
Telephone triage plays an important role in managing demand for health care. Important questions are whether triage decisions are appropriate and patients comply with them.


METHODS
CINAHL, Cochrane Clinical Trials Database, Medline, Embase, Web of Science, and Psyc Info were searched between 1980-June 2010.


METHODS



METHODS
Rapid Evidence Synthesis.


METHODS
The principles of rapid evidence assessment were followed.


RESULTS
We identified 54 relevant papers: 26 papers reported appropriateness of triage decision, 26 papers reported compliance with triage decision, and 2 papers reported both. Nurses triaged calls in most of the studies (n=49). Triage decisions rated as appropriate varied between 44-98% and compliance ranged from 56-98%. Variation could not be explained by type of service or method of assessing appropriateness. However, inconsistent definitions of appropriateness may explain some variation. Triage decisions to contact primary care may have lower compliance than decisions to contact emergency services or self care.


CONCLUSIONS
Telephone triage services can offer appropriate decisions and decisions that callers comply with. However, the association between the appropriateness of a decision and subsequent compliance requires further investigation and further consideration needs to be given to the minority of calls which are inappropriately managed. We suggest that a definition of appropriateness incorporating both accuracy and adequacy of triage decision should be encouraged.
ScHARR, University of Sheffield, UK. l.blank@sheffield.ac.uk
Lindsay
L
Blank
Joanne
J
Coster
Alicia
A
O'Cathain
Emma
E
Knowles
Jonathan
J
Tosh
Janette
J
Turner
Jon
J
Nicholl
D003657:Decision Making; D004632:Emergency Medical Services; D015277:Hotlines; D006801:Humans; D009726:Nurses; D010349:Patient Compliance; D010820:Physicians; D011320:Primary Health Care; D011787:Quality of Health Care; D017216:Telemedicine; D013689:Telephone; D014218:Triage