Triageof Walk-ins

Date Reviewed: 05/05/2014 LS

OBJECTIVE:

To correctly identify, advise, and prioritize patients in need of medical care.

EQUIPMENT:

  1. Patient Chart
  2. EHR
  3. Barton D. Schmitt Pediatric Telephone Protocols 12th Edition

INSTRUCTIONS:

Walk in Triage

  1. If the patient walks-in and is showing any signs of distress or in need of immediate medical care, the first responder, whether a clinical staff member or not will notify the appropriate provider or nurse to assess the patient
  2. Walk-ins will be placed in the overflow column. The nurse assigned to triage that day will watch the overflow column in EPM for walk in patients to be placed
  3. Prioritize emergent issues first
  4. Call patient back to a room to triage
  5. Follow the process listed below- to determine if they need seen by a provider
  6. If patient needs to be seen, move patient from the overflow column to an appropriate walk in slot with visit detail charted. Communicate with provider and flow coordinator as necessary.

Triage

  1. Assess emergent walk-insfirst. Assess non-urgent walk-ins second and in the order they were received.
  2. Select the correct protocol
  3. Identify the main problem or symptom and go to that protocol.
  4. If the child has multiple symptoms, always select the most serious symptom.
  5. Triage the patient
  6. Scan the bulleted checklist of indicators for seeing patients.
  7. Stop asking questions as soon as you elicit a positive response.
  8. Giving Home Care Advice
  9. Review home care advice with most walk-ins.
  10. Identify what treatment the parent/patient has tried previously.
  11. Provide reassurance whenever possible.
  12. Try to limit your advice to 3 instructions and keep comments brief.
  13. Ask if parent/patient has any questions.
  14. End each assessment with callback instructions or reasons to return to the office or ED for further care. Covering every worse-case scenario.
  15. Document the assessment
  16. Search Patient Name & Date of Birth
  17. Review 4 Checkpoints
  18. Add NEW Encounter when applicable
  19. Select Telephone Call Template
  20. Medical Question
  21. Enter Contact Type
  22. Spoke with Name and Relationship
  23. Telephone Number
  24. Communication
  25. Concern and Comment
  26. What is the main symptom?
  27. Describe symptoms, duration, what patient/parent has done at home
  28. Urgency
  29. Brief comment of what the walk-in pertains to (ie, medical question, med refill, referral)
  30. Actions
  31. Decide according to Protocol if patient needs to be seen or home advice given
  32. If patient is not being seen at the time of walk-in, open appointment under walk-in overflow and note “Patient triaged, not seen, see detail in Telephone call template”
  33. Document Protocol used
  34. Check mark Counsel Patient
  35. Enter Protocol name
  36. Check completed at Action Level
  37. Chart to Provider
  38. After reviewing telephone protocols, if additional advice is needed or medication is required taskinformation to individual Provider.
  39. Inform patient/parent they will receive a call back by the end of the day or first of the morning regarding their request.
  40. If no further action or tasking is required, render status complete.

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05/05/2014 LS