The Value of Nurse Triage: Interview with RelateCare Director of Nursing, Clinical and Wellness

Next in our RelateCare Consultancy and Advisory series, we talk to our Director of Nursing, Clinical and Wellness, Kari Kontz about our Nurse Triage programs.

RelateCare’s Nurse Triage program is a telephonic clinical solution whereby patients can avail of direct access to a Registered Nurse at any time, day or night. The main purpose of this program is to be available to patients, so they can seek care and medical advice when and where they need it, therefore increasing the level of patient access offered to patients by a provider. But it also has the added benefit of reducing pressure on overwhelmed health systems by caring for patients while they are still at home, so they can avoid making an unnecessary visit to a hospital.

This ensures that hospital physicians are seeing patents that really need it urgently, while providing others an appropriate appointment to be seen and patients can get the reassurance they need and that they are getting the most appropriate care. This certainly allows for better patient satisfaction.

Organizations across the country are finding it increasingly difficult to recruit and retain nursing resources. By acting as a virtual extension to our partners in-house clinical operations we can have a meaningful impact on our strategic partners as well as their patient population.’’

How does it work in practice?

“Basically, it starts with a phone call. A patient makes a call to a dedicated number, or to their healthcare provider seeking assistance. This could be for a variety of reasons (to schedule an appointment, medication refills), but often it is due to the presence of symptoms that are causing distress and worry.

The call is answered directly by the Registered Nurse, or else is answered by a scheduling representative, who can direct the patient via warm transfer to the Registered Nurse. It is also possible that automated technology can filter the calls to ensure high-risk patients get bumped up the queue.

Once connected with the patient, the goal of the RN is to get as much information as possible and to gain an in-depth understanding of the patients’ symptoms and medical history so they can determine the correct care pathway.’’

What protocols do the nurses use?

“Our RNs leverage the Schmitt-Thompson protocols in order to properly assess the patient’s symptoms, while eliciting further information to gain more insight and specifics into the patients’ symptoms. Known as the gold-standard of triage, the Schmitt-Thompson protocols strengthen organizations clinical decision support (never taking away nursing experience, critical thinking, and clinical nursing judgment) and help RelateCare RNs to give high-quality healthcare advice and the most suitable level of clinical care pathway for patients.

This can range anywhere from immediately calling 911, down to supporting patients with offering simple care advice, refilling medications, or scheduling an appointment with their physician and referring the patient back into the healthcare system.

Throughout the call, all the relevant information about the patient and their current situation is documented directly in real time into the Electronic Health Record system of the healthcare provider and larger clinical team.”

What are the benefits of having a Nurse Triage program?

“Ultimately it allows for improved continuity of care for our client partners, who are often hospitals and health systems. The patient gets access to care when they are outside the hospital, but in such a way that the patient always remains connected.

When we work with a health system to provide Nurse Triage our team of RN’s can be in direct contact with the patient’s care team through phone, secure text messaging, or in-basket messages at all times. The patient can be confident that their care team will remain engaged and informed about their symptoms and treatment plan.

RelateCare’s RN Nurse Triage program standardizes telemedicine care approaches, increases quality, and ultimately creates a more efficient process for assessing and caring for patients.

Ultimately, Nurse Triage saves lives, and our goal is to ensure proper medical care is extended to as many people as possible. This has become ever more important due to COVID-19.”

Has COVID-19 effected the need for Nurse Triage?

“COVID-19 has allowed for the technology piece to really grow, and providers and patients are more willing to invest in the technology and personnel to deliver a really robust Nurse Triage program. This allows them to really limit the risk of the spread of infection while maintaining patient care and engagement.

This will likely  stay beyond COVID-19, I think. The pandemic  has enabled the technology solutions to be embraced, but once the threat of the virus dissipates, health systems will still need to take care of patients and reach out and have access for your patients, virtually, remotely from a distance.”

What does it take to be a Nurse working on this program?

“It takes a pretty experienced Registered Nurse to become a part of our Nurse Triage solution.

We are dealing with everything from cradle to grave and with that, its triaging the simplest things from cold and flu and runny nose all the way up to the very difficult complex hard to handle type calls, 911, suicide, overdose, and abuse. Our nurses are very equipped to handle all those types of calls. Sometimes in our industry people forget to think of the depth that is there in a successful Nurse Triage.

In essence we want nurses that have experience; experience of the day to day, who have learned the trade, learned to troubleshoot, use their nursing skills. So usually, Nurses with several years nursing experience, nurses with critical care, ICU emergency room background, as they try to troubleshoot difficult patients.”

Is it always general triage or do you specialize?

“We do both. We have a range of specialist programs that are specifically for Cardiac or OBGYN or Neurology. We have the capacity and the flexibility to tap into a range of expertise to allow us to develop specialist nurse triage lines for each area.

We can pretty much create a program that is tailored and designed to any specific needs. We are constantly developing and deploying training modules and upskilling our nurses for special programs.

Because we operate within a trust-based partnership with our clients, this allow us to tap into their Chief Medical Officer or head of Orthopaedics to provide webinars or seminars to educate our nurses on the latest things that are happening. Healthcare is always changing, like diabetes medications, and for our nurses to be exposed to that is essential if we want to keep delivering the same excellent care we are known for.”

What kind of feedback do you hear from your partners and their patients?

“I have been involved  in every nurse triage program that RelateCare has deployed. It has been genuinely enjoyable to see first-hand the impact these programs have on our hospital partners as well as the patients we communicate with daily.

As we know, physician burnout is a hot topic across the country. We have seen examples whereby on call providers have questioned whether their pager was working or not due to the dramatic positive reduction in escalations coming their way.

From a patient perspective, you can often hear the relief and joy in a patient’s voice when they realize they are speaking with a member of our Registered Nurse team. As our programs extend 24/7/365 patients seem to be particularly satisfied when they realize they have someone to speak to around the clock.”

What is next for RelateCare’s Clinical and Wellness division?

“We are always looking at ways to improve and expand our service offerings.  We recognize that healthcare delivery continues to evolve. We believe we will continue to play a pivotal part in keeping patients healthy and engaged beyond the traditional four walls of a hospital. We will continue to expand from Nurse Triage, Health and Wellness Coaching, Care Coordination, or Discharge Follow-up. If you are looking to learn more about our offering, I would encourage healthcare leaders to get in touch with myself or our team! We would be delighted to answer any questions you have!

About The Author

Kari Kontz is Director of Nursing, Clinical and Wellness programs at RelateCare. At RelateCare, Kari specializes in the creation, design, and implementation of Clinical Communication Programs such as; 24/7 Centralized Telephonic Nurse Triage services, Post Discharge Follow-Up, Clinical Quality Assurance Support Programs and Clinical Outreach programs. Kari has acted as a key advisor working with RelateCare’s partners to advise leadership on triage protocols, omnichannel utlization, call flow/scripting, escalation pathways, recruitment, and training of suitable qualified personnel. Prior to joining RelateCare, Kari worked as a Registered Nurse at MedStar Georgetown University Hospital in DC and was awarded Nurse of the Year in 2010.