1. Telephone Triage in the Emergency Department: A Collaborative Outcome
Lincoln Medical & Mental Health Center
member of NYC Health & Hospitals Corporation(HHC)
member of Generations+/Northern Manhattan Health Network

2. Purpose
Meet the challenges of Managed Care by providing the South Bronx community an effective alternative to access healthcare.
Decrease overcrowding in the ER

3. Goals Provide an alternative to the ER for low acuity problems Improve
the quality and reliability of the service
Provide the community with reliable access to heath care information
Facilitate appointment for
managed care
patient to
primary
care services

4. PI Methodology
P - lan
D - esign
M – easure
A - ssess
I - mprove

5. PDMAI Approach Design Procedures/Protocols Patient Pediatric Protocols
Procedures/Protocols
Patient
Pediatric Protocols
Awareness/ understanding
of the service
Adult Protocols
Patient Acuity
Assessment Protocol
Quality
Telephone Triage
Language barrier
Computers
Management and
follow-up of panic values
Cyracom Phones
Follow-up on “no answer”
TTY Machine
Staffing effectiveness
Community outreach
/education materials
Phone rings a long time
before being answered
Quality of Care
Provider
Environment/
Equipment

6. Triage RN may consult with provider/PCP at anytime during the process
Design
Triage RN may consult with provider/PCP at
anytime during the process
Patient initiates
phone contact
Call comes into
Telephone Triage unit
Call comes
into ER
Call comes from
laboratory
Panic Values
Call comes into
appointment unit
Clerk answers
phone
RN answers
phone
Yes
Urgent? No
RN assesses situation
Clinic
appointment
scheduled
Advice
only
Emergent call
Urgent call
Appointment
only
LMMHC/Belvis/Morrisania
RN gives patient appointment
(24 hour window)
RN documents
case
Appointment unit
notified of time frame
for appointment
Patient referred to
nearest ER or
911 contacted
Follow-up of all pediatric
and some adult cases
Follow-up on ER Referrals
LMMHC/Belvis/Morrisania
Call transferred to appointment unit

7. Patient Disposition Emergency Referral Urgent (Same day)
Urgent clinic appointment (within 24-
48 hrs)
Clinic appointment (48-72hrs) - sick visit but not urgent
Clinic appointment (visit within four days or more) - not a sick visit

8. Telephone Triage History
7/29/96 - Lincoln Pediatric calls
9/06/96 - Lincoln Adult calls
5/ Belvis Pediatrics and
Adult calls
10/ Other clinic Pediatric and
Adult
4/24/00 - Morrisania Pediatric and

9. Total Number of Calls