Monday, July 26, 2010

Taking Control of The Call

To be an effective telephone triage nurse, you must not only give accurate advice according to the protocols, but the call must also be completed in a timely manner. Most calls can be completed in 3 to 5 minutes. Some of the more complicated ones, such as those you have to page a physician for, can sometimes take as long as 15 min for more.
In order for the call to be completed in that 3 to 5 minute window, you must take control of the call from the first second the caller answers. Let's examine further how to accomplish that.
First things first. Get the housekeeping stuff out of the way. By that, I mean verifying spellings, dates of birth, etc.(Make sure the demographics are correct.) Nothing messes with a billing statement more than to have 1 patient with 4 different spellings of the name. Also, with varied accents, and telephone reception, many letters sound the same. So, when you have similar letters such as "d" and "b", it is always a good idea to verify using examples. For instance, you can say, "Do you spell Abby, A, b as in boy, b as in boy, y?". This decreases errors dramatically.
Next, in obtaining the medical history, it is not necessary to obtain all of it, just what is pertinent to the current situation. Medications and allergies should also be obtained and this could include any OTC medications that the pt is taking.
There are certain questions that you should never ask in order to keep the call under control, and quickly gather the assessment information that you need. You should always ask questions that require short, quick responses if possible. One question that should be removed from your vocabulary is, "Tell me what is going on tonight". That leaves the caller wide open to give you any information they want including information that may not obtain to the situation at hand. This leaves you taking longer time trying to decipher what information you need and what you don't.
Stick to the questions in the protocols. If you ask all of those that pertain, you will have a complete picture of what is really going on, and the information will be obtained in a lot less time. If the caller starts to wonder off in the conversation, you can redirect politely by saying, "Let's get back to that in a second.I need to ask you some questions first".
Make the call flow from beginning to end, just like your documentation. Gather all of your assessment information before giving advice. If you skip around, you may miss some valuable bit of information, plus it adds more time to your call. And, by continuously asking all the questions in the protocols, it does not leave time for the caller to think of unnecessary information to tell you.
Finally, smile and be reassuring! Explain to the caller why you are giving the advice that you are. This is the time to educate, but keep it in understandable, layman's terms. Reassure them that they are not alone, and instruct them when they need to call back and what to watch for. If you are reassuring and give them all the information they need to feel empowered, they are more likely to give a good report back to their physician and less likely to call back several times in the same night with more concerns or questions on the same issue.

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