Telephone triage

 

  • Positivity – “Come down and we’d be delighted…..”
  • Incentives – Seen faster / No delay
  • Politeness & open-mindedness (professionalism)
  • Good communication skills – Ensuring that the patient understands what you’re talking about
  • Clarification is essential
  • Who’s problem ( Why me? Why now?)
  • Consider medico-legal aspects
  • Confidentiality – Is this the patient ? If not why not ?
  • Be flexible
  • Reward good behaviour
  • Keep options open
  • Address anxiety
  • Explain plan – “If no better…then contact us again”
  • Give patient options

Telephone vs. face to face

Telephone Face-to-face
  • History only
  • No previous relationship
  • Knowledge of past medical history
  • Not necessarily talking to patient
  • More difficult to establish rapport
  • Easier to put people off
  • Easier to push dr’s agenda
  • Difficulties of being recorded (this changes the very nature of the consultation)
  • More difficult to assimilate information
  • Difficulty interpreting symptoms & signs
  • Deal with a greater workload
  • Easier when patients only want reassurance
  • May speed decision making in acute situations
  • Patient expectation – people expect visits
  • Misunderstandings may occur
  • What if no phone?
  • Difficulties less if own dr.
  • Face to face
  • Opportunity to examine
  • Body language / physical pointers
  • Easier to communicate wheh have all other aspects (visual contact etc.)
  • Harder to avoid the problem
  • Easier to establish rapport & empathy
  • Can observe other aspects (social / family)
  • ? Encourages dependence on face to face contacts whereas advice may encourage self-reliance

Improving triage techniques

Using telephones in primary care Peter D Toon BMJ 2002;324 1230-1231

 

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