title: [Practice assistant sometimes misses urgent request for help: telephone triage in general practice].
abstract: OBJECTIVE
  To assess the organisation and appropriateness of telephone triage in general practices in the Netherlands.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Via e-mail we invited all members of the Dutch Association of practice assistants to complete an online survey. The questionnaire included questions about practice assistants' background characteristics and the practices' triage organisation. Furthermore, they were asked to assess the indicated type of care for a number of fictive case scenarios involving a variety of health problems and levels of urgency. To determine the appropriateness of the respondents' assessments, each was compared to a reference standard agreed by experts. In addition, the association between practice assistants' background characteristics and organizational setup of the triage organisation with the appropriateness of triage was examined.
  
  
  RESULTS
  The response rate was 41.1% (N=973). The required care was assessed appropriately in 63.6% of the cases, over-estimated in 19.3% and under-estimated in 17.1% of cases. The sensitivity of identifying patients with a highly urgent problem was 76.7%, whereas the specificity was 94.0%. The appropriateness of the assessments of the required care was higher for more experienced assistants and assistants with regular daily work meetings with the GP. Triage training, use of a triage tool and authorization of advice provision were not associated with appropriateness of triage.
  
  
  CONCLUSIONS
  Triage by practice assistants in general practices is efficient, but potentially unsafe in highly urgent cases. It is therefore important to train practice assistants in the identification of highly urgent cases.
authors.affiliation: *Dit onderzoek werd eerder gepubliceerd in Scandinavian Journal of Primary Health Care (2016;34:28-36) met als titel 'Telephone triage in general practices: a written case scenario study in the Netherlands'. Afgedrukt met toestemming.
authors.forename: M
authors.initials: M
authors.lastname: Smits
authors.forename: S
authors.initials: S
authors.lastname: Hanssen
authors.forename: L
authors.initials: L
authors.lastname: Huibers
authors.forename: P
authors.initials: P
authors.lastname: Giesen
mesh_terms: D003430:Cross-Sectional Studies; D058006:General Practice; D006801:Humans; D009426:Netherlands; D011795:Surveys and Questionnaires; D013689:Telephone; D014218:Triage / Q000458:organization & administration*