Triage nurses are key members of the care team, able to provide many aspects of care in various environments. These environments include hospice, home care, physician groups, accountable care organizations (ACOs) and insurers. In this blog, we break down the role of a triage nurse in each of these different environments and the critical role they play in the patient and caregiver experience.

Triage for Hospice

Hospice care is a highly specialized service for terminally ill patients, and as such, this kind of care is delivered by highly trained, compassionate nurses. We understand that the transition to end-of-life care is very difficult for families, which is why nurse triage for hospice is designed to give patients and family members peace of mind knowing that a trained hospice nurse is available – day or night – to provide compassionate care and support.

Triage for Home Care

Home care allows a person with specialized needs to remain in their home. While the conditions for entering home care may be different – patients who are aging, chronically ill, recovering from surgery or disabled – the services typically include:

  • Personal care, such as help with bathing or getting dressed
  • Homemaking, such as cleaning, yard work and laundry
  • Healthcare, such as having a home health aide come to the home

Those who choose home care are treated by a team of healthcare professionals that provide medical care uniquely designed for home-based treatment. A core member of this team, the triage nurse, is the first line of defense after-hours. As opposed to a call center or answering service that simply directs calls to on-call staff, the triage nurse is trained in the home care setting and able to deliver quality care, such as medication refills and symptom management, as soon as a patient or caregiver calls. Though home care does not deal with end of life, many patients are facing long-term illnesses that require specialized nurses who are able to assess the situation and determine the best course of action for the patient. 

Triage for Physician Groups

Primary care physicians treat hundreds of patients every month. With a patient mix of pediatric, geriatric, middle age and everything in between, it can be difficult for physicians to manage the needs of every patient. This is where their nursing staff comes into play. For many physician groups, their nurses have become the first line of defense for patient engagement. Because of the added responsibilities of providing live care, remote care and after-hours care, nurse burnout and turnover levels are historically high. To combat this and support both staff nurses and physicians, nurse triage for physician groups easily integrates into the after-hours care model and begins to take calls immediately. More importantly, the service provides licensed nurses in your state that have experience across different demographics, specialties and triage training that can allow them to address a variety of patient concerns. Without this added level of licensed nurse based care, physician groups are forced to keep their antiquated medical call center in place, providing little to no value to their patients.

Triage for ACOs

Accountable Care Organizations (ACOs) are groups of doctors, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings it achieves for the Medicare program. In order to do this successfully, ACOs have begun looking to triage nursing services to help deliver the needed care, 24/7. ACOs have realized that the specialized training triage nurses have can provide extreme value to their patient populations by helping to reduce unnecessary ER visits by providing licensed nurse care when the patient needs it.

Triage for Insurers

Insurers are responsible for the overall health of entire geographic populations in the U.S.. Many insurers have implemented remote nurse advice lines to help provide care to their populations. In this setting, triage nurses are required to have knowledge across a vast array of specialties and guidelines that provide:

  • General health information
  • Self-care instructions when appropriate
  • Guidance on whether to see a doctor
  • Physician and/or service referrals
  • Escalation to emergency services
  • Follow-up call to the member

In most cases, the nurse advice line is available at no extra cost to members and helps patients make informed decisions about self-care at home or when to see a health care provider. Registered triage nurses educate the members on their health and provide guidance on treatment options and available resources in their area—allowing them to make informed healthcare choices.

The Many Roles of a Triage Nurse

Triage nurses coordinate the overall care plan, educate patients and caregivers on their healthcare, provide hands-on care and give advice and compassionate support over the phone. In organizations that prioritize patient experience, nurses will perform the following functions:

  • Intake Admission Nurse
    The intake admission nurse is responsible for assessing needs and consults with the physician before accepting a patient into the program.
  • Case Manager Nurse
    A case manager is responsible for assessing and managing the overall plan of care. Once admitted to any program, the case manager nurse will do a complete assessment of needs and fill the physician’s orders for medication and equipment. Ideally, only one case manager nurse is assigned to each patient in order to foster a trusting relationship and allow for continuity of care.
  • Visit Nurse
    A visit nurse makes in-person visits to patients with immediate needs and follow up on routine care. Most healthcare agencies have visit nurses on-call after hours to take care of urgent needs.
  • Triage Nurse
    The triage nurse is available to take phone calls from patients and families. Over the phone, they assess the patient’s situation and provide instructions for symptom management or medical treatment. The triage nurse consults with the primary physician and notifies the case manager or visit nurse if there’s a need for a visit.

If you have ever wanted to explore switching from an antiquated medical call center model to a nurse-based triage model, contact us today to learn more.

This post was originally published in September 2018 and has been completely revamped and updated for accuracy and comprehensiveness.

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