Assessing the feasibility of a pre-triage photo and questionnaire protocol in GP triage: a quality improvement study

Efficient triage in general practice is critical to optimize appointment allocation and minimize patient delays. Delays in receiving clinical information, such as photographs or symptom questionnaires, lead to unnecessary consultations and inefficiencies. This study evaluated the feasibility and impact of a structured pre-triage protocol requesting photos and questionnaires for common conditions (skin, eye, tonsillitis, and urinary tract infections).

A pre-post intervention quality improvement project was conducted in a UK general practice. Triage administrators were instructed to proactively request photographs for skin and eye complaints and symptom questionnaires for tonsillitis and UTIs at initial patient contact. Outcomes included process metrics (number of pre-triage requests, proportion of cases managed directly by the triage GP) and subjective measures of ease, speed, satisfaction, and confidence.

The protocol increased photo requests for skin (mean increase 4.0/session, Cohen's d = 7.77) and eye (2.2/session, d = 4.09) conditions, while questionnaire requests remained unchanged. The proportion of skin cases managed directly by the triage GP increased significantly (from 0.2 to 2.2 cases/session, d = 1.65), and eye case management also improved. Questionnaire-based pathways showed minimal change in efficiency or direct management. Subjective feedback indicated a slight reduction in triage speed, but ease and satisfaction were maintained, while diagnostic confidence increased, particularly for photo-supported conditions.

A structured pre-triage protocol is feasible, acceptable, and potentially effective in enhancing triage efficiency, particularly for visually assessable conditions like skin and eye presentations. By enabling earlier access to essential information, such protocols may reduce unnecessary consultations, improve workflow, and support clinician confidence.