• Tim A Holt, Emily Fletcher, Fiona Warren, Suzanne Richards, Chris Salisbury, Raff Calitri, Colin Green, Rod Taylor, David A Richards, Anna Varley, and John Campbell.
• Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford.
• Br J Gen Pract. 2016 Mar 1; 66 (644): e214-8.

BackgroundTelephone triage is an increasingly common means of handling requests for same-day appointments in general practice.AimTo determine whether telephone triage (GP-led or nurse-led) reduces clinician-patient contact time on the day of the request (the index day), compared with usual care.Design And SettingA total of 42 practices in England recruited to the ESTEEM trial.MethodDuration of initial contact (following the appointment request) was measured for all ESTEEM trial patients consenting to case notes review, and that of a sample of subsequent face-to-face consultations, to produce composite estimates of overall clinician time during the index day.ResultsData were available from 16,711 initial clinician-patient contacts, plus 1290 GP, and 176 nurse face-to-face consultations. The mean (standard deviation) duration of initial contacts in each arm was: GP triage 4.0 (2.8) minutes; nurse triage 6.6 (3.8) minutes; and usual care 9.5 (5.0) minutes. Estimated overall contact duration (including subsequent contacts on the same day) was 10.3 minutes for GP triage, 14.8 minutes for nurse triage, and 9.6 minutes for usual care. In nurse triage, more than half the duration of clinician contact (7.7 minutes) was with a GP. This was less than the 9.0 minutes of GP time used in GP triage.ConclusionTelephone triage is not associated with a reduction in overall clinician contact time during the index day. Nurse-led triage is associated with a reduction in GP contact time but with an overall increase in clinician contact time. Individual practices may wish to interpret the findings in the context of the available skill mix of clinicians.© British Journal of General Practice 2016.

26 keywords...

hide…