Quantifying Telephone Triage Productivity: Looking for the Most Accurate Measure (Spotlight Poster)

Financial stewardship is a priority in healthcare today. Return on investment (ROI), productivity, and quality are key indicators for every organization. A telephone triage program relies on efficiency in productivity and staffing to ensure that quality patient care is being provided.
In reviewing the literature, there was limited information about telephone triage nursing productivity. Comparisons are made with non-nursing call centers looking at the number of calls managed hourly. Surveys have been completed by Schmitt Thompson Clinical Content (STCC, 2023) to try to establish a consensus on the average number of calls triage nurses can manage per hour. This does not consider the type of phone calls, the setting in which phone calls are taking place, or the complexity of the encounter. When determining staffing, we must account for all of these factors to ensure safe staffing.
Evaluating the length of the triage phone call is one way call centers establish their staffing ratios; however, with telephone triage, this does not always equate because of the intricacies of the practice and varied work settings. “In a healthcare call center, the patient experience takes priority which renders many standard call center metrics meaningless” (Envera Health, 2023). The nursing process required to care for a patient includes an assessment, diagnosis, planning, implementation, and evaluation. Critical thinking and nursing judgment are crucial in the delivery of safe care. Assigning a time limit or parameter on this may lead to poor outcomes for our patients. When we examined our program’s length of phone calls, our values fit into the standard survey results of an average of 4 patient calls/hour. Our length of calls average for FY2024 was 9 minutes and 31 seconds. When we evaluated the length of the entire encounter, our time for FY2024 team time was 29 minutes and 50 seconds. Length of encounters included documentation, contacting on-call providers to discuss care, and contacting pharmacies about prescriptions. This information is not calculated with a single length of call value.
After tracking this data over 12 months, we determined that comparing encounter times gave us better feedback for evaluating nursing practice and productivity. We now set benchmarks for our program and monitor individual nursing practices with this data. Plans include evaluating encounter lengths based on protocols used, the reason for the call, and determining if changes in our practice are necessary for patient safety and the efficiency of our program. Establishing a staffing model based on this information compared to the call center's limited length of call data may be best practice. It is not just talking time with nursing telephone triage. It’s coordination and management of the patient's current symptom or situation, ensuring the triage nurses are giving the most appropriate disposition and the patient can carry out that plan of care.