Priority Queue in the Setting of Nurse Triage (Spotlight Poster)

Problem statement: Patients calling to schedule appointments often speak to non-clinical personnel unqualified to offer medical advice. At this call center, there was not an efficient method to transfer callers with designated high-risk symptoms to a registered nurse. Patients were placed on hold and transferred to a registered nurse in the order calls were placed regardless of symptomology. This led to a delay in high-risk patients being triaged and the possibility of patients hanging up prior to speaking with a registered nurse, missing an opportunity to address immediate health needs.
Project intent: The intent of this project was to improve the process at a call center for non-clinical staff to connect patients with high-risk symptoms to a registered nurse.
Methodology: The nursing triage team collaborated with telecom to develop a priority queue within the current telephone software. The priority queue was built to move patients to the front of the wait list based upon high-risk symptoms rather than call order. The priority queue was assigned a dedicated phone number only provided to the non-clinical call center staff to utilize when high-risk symptoms are identified.
Results: Prior to implementation of a priority queue, the estimated average wait time was five to ten minutes. Three months after implementation, identified high-risk patients are speaking to a registered nurse in an average of 39 seconds with a maximum wait time of four minutes and 16 seconds. This is below the Schmitt-Thompson recommendation of high-risk patients speaking to a registered nurse in under five minutes.
Conclusions/implications for nursing: Time can mean the difference between positive or negative patient outcomes, and even life or death in certain situations. This quality improvement project demonstrates how nurses, in collaboration with other disciplines, can work to identify and implement novel technologic solutions to decrease time patients with high-risk symptoms must wait to speak to a registered nurse.