Exploring two-step and one-step urgent care telephone triage: a UK-based semi-structured interview study

Area of Science:

• Healthcare Management
• Patient Experience Research
• Urgent Care Services

Background:

• Two urgent care telephone triage models exist in the UK: one-step (clinician-led) and two-step (non-clinician followed by clinician).
• Digital triage (computerised decision support) may be integrated into both models.
• Patient experiences of two-step triage are not well understood.

Purpose of the Study:

• To explore and compare patient and carer experiences of two-step urgent care triage versus one-step triage.

Main Methods:

• Semi-structured interviews were conducted with 25 patients/carers in England and Northern Ireland.
• Interviews occurred between July 2021 and February 2022.
• Thematic analysis was employed, using Oben's framework for interpretation and SRQR for reporting.

Main Results:

• Two-step triage was associated with complexity, delays, and patient frustration.
• Communication with non-clinicians was perceived as scripted and inflexible.
• Clinician communication was viewed as more natural and empathetic, providing reassurance that sometimes enabled self-care.

Conclusions:

• Service planning for two-step triage should prioritize minimizing patient-experienced complexity.
• Further research is needed on adapting digital triage for natural communication flow and leveraging empathetic communication for self-care.
• Clinician training should emphasize empathetic communication and adequate patient time during triage.