S.F.ONG1, C.W.TEW1, A.B.A.SEREEBU1, B.X.Y.TAN1, Y.H.ANG1
Khoo Teck Puat Hospital1
THINK centre provides telephone triage services by trained registered nurses supported by structured interview questionnaires and protocols. This study aims to evaluate the accuracy of telephone triage by nurses based on subsequent Emergency Department (ED) attendances and hospitalisations.
This retrospective cohort study reviewed all completed teletriage calls from March to June 2021. Patients triaged as C1 were recommended to attend ED immediately, while those triaged as non-C1 (C2-5) were recommended dispositions other than ED. Patients’ conditions were considered true emergencies if they were assigned P1 or P2 acuity on presentation to ED or was admitted within 24 hours of the call. Sensitivity and specificity for accurate triage of emergencies were determined.
Sixty-six calls were included. Of these, 19 were C1 and 47 were non-C1. Mean age in C1 was 76.5 years and non-C1 was 76.0 years. Proportion of males was 42.1% in C1, and 51.1% in non-C1. Most were frail (68.4% in C1; 57.4% in non-C1). 58 patients were triaged appropriately, 7 were over-triaged as emergencies and 1 patient was under-triaged as a non-emergency. Nurse telephone triage detects emergencies with a sensitivity of 92.3% (95% CI 64.0-99.8%) and a specificity of 86.8% (95% CI 74.7-94.5%) and an accuracy of 87.9% (95% CI 77.5-94.6%).
The study findings reflect good accuracy and safety of telephone triage by nurses. While we acknowledge limitations of sample size and using acuity at ED attendances and admissions as gold standard for triage accuracy, the study findings can inform future telehealth practice and research.