Ask ECRI: Telephone Triage for New Patients

October 10, 2018 | Ambulatory Care Risk Management


​​​A risk manager recently asked for guidance in conducting telephone triage for new (nonestablished) patients who call the office with a clinical complaint. In particular, patients may describe symptoms such as headache or chest pain and be transferred to a nurse or physician, who would then be tasked with treating a patient for whom they have no record. In such situations, the member asks, should patients immediately be directed to the closest emergency department (ED) or urgent care center?

In our response, ECRI Institute notes that there are risks in having nurses or doctors try to make clinical decisions based only on a phone call. There may also be risks in having customer service representatives triaging these issues and directing patients to take particular courses of action, based on a clinical complaint but without the involvement of clinical staff. Discussions with clinical and administrative leaders, nurses, and customer service representatives might help the physician practice in...

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