Triage

The video above provides an overview of triage within a remote consultation and introduces some important research into the impact and effectiveness of triage in primary care. You can access the GMC flowchart discussed in the video here. Watch this video first before accessing the further reading below.

Further reading

We have provided three articles which present an overview of how triage has been applied in practice.

The first two articles are an analysis of the use remote consultations in UK GP surgeries and in Dutch out of hours centre.

The Dutch study (Derkx et al, 2008)[1] analyses the quality of care based on how patients were triaged by the clinicians. Read the methods section, results section and conclusion in this paper, paying particular attention to the obligatory questions to be asked for each case in the methods section.

The UK study (Campbell et al. 2014)[2] assesses the effectiveness and cost of GP-led and nurse-led telephone triage compared with face-to-face care for patients seeking same-day consultations in primary care. Read the discussion section to see how the authors came to the conclusions on the cost effectiveness of the use of this model in primary care and the benefit of triage on primary care services.

The final article (Mansab, Bhatti and Goyal, 2020)[3] is a recent analysis of the use of triage in the COVID-19 pandemic. It is an important analysis of how the UK, in particular, fared against other countries in the world. In the conclusion of the paper, there are further discussions on how appropriate triage is important to counter risks when remotely managing patients.

If you are interested in reading these studies in full, you can go ahead and read through the rest of the papers in your own time.

Bibliography

[1] Hay P Derkx, Jan-Joost E Rethans, Arno M Muijtjens, Bas H Maiburg, Ron Winkens, Harrie G van Rooij, J André Knottnerus. Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study. BMJ 2008;337:a1264.

[2] Campbell J, Fletcher E, Britten N, et al. Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster randomised controlled trial and cost-consequence analysis. Lancet. 2014;384:1859–1868.

[3] Mansab F, Bhatti S and Goyal D. Patient-Led COVID-19 Triage Systems and Case Fatality Rates: A Comparative Study Between Singapore, Japan, Norway, the USA and the UK