Ask HRC: Using ICU Nurses for After-Hours Telephone Triage

An HRC member recently inquired about the use of intensive care unit (ICU) nurses to handle some after-hours calls to the hospital's health information hotline. The hospital will eventually move to contracted health call center staff, but intends to use ICU nurses equipped with commercial telephone triage software that includes patient care protocols in the interim. In response, HRC notes that, although the use of ICU nurses to answer the calls is time-limited, lasting approximately four months, the situation raises several patient safety and risk management issues.

The first concern is staffing. If the ICU nurses assigned to answer telephone calls also have a concurrent patient care assignment, conflicts can arise. Due to the often unstable and unpredictable nature of critically ill patients, an ICU nurse's primary obligation rests with the patients in the unit. Other responsibilities such as answering phone calls can cause distractions...