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[Practice assistant sometimes misses urgent request for help: telephone triage in general practice]
M Smits1, S Hanssen, L Huibers
1*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.
Nederlands Tijdschrift Voor Geneeskunde
|August 4, 2016
Summary
Telephone triage by practice assistants is efficient but can be unsafe for urgent cases. Further training is crucial for practice assistants to accurately identify highly urgent patient needs.
Area of Science:
- Healthcare Management
- Primary Care
- Nursing Practice
Background:
- Telephone triage is increasingly utilized in general practices.
- Assessing the quality of telephone triage is essential for patient safety.
- Practice assistants play a key role in primary care triage.
Purpose of the Study:
- To evaluate the organization and appropriateness of telephone triage systems.
- To identify factors influencing the accuracy of triage decisions.
- To assess the safety and efficiency of triage by practice assistants in the Netherlands.
Main Methods:
- Cross-sectional observational study utilizing an online survey.
- Involved 973 practice assistants from the Dutch Association of practice assistants.
- Assessed triage appropriateness against an expert-defined reference standard using simulated case scenarios.
Main Results:
- Overall appropriate care assessment in 63.6% of cases; under-estimation in 17.1%.
- High specificity (94.0%) but moderate sensitivity (76.7%) for identifying urgent cases.
- Appropriateness linked to assistant experience and collaboration with General Practitioners (GPs).
Conclusions:
- Telephone triage by practice assistants is efficient but poses risks in highly urgent situations.
- Experience and GP collaboration enhance triage appropriateness.
- Targeted training is recommended to improve the identification of urgent cases.
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