An evaluation of service user experience, clinical outcomes and service use associated with urgent care services that utilise telephone-based digital triage: a systematic review protocol

Sexton, Vanashree; Dale, Jeremy; Atherton, Helen

doi:10.1186/s13643-021-01576-x

Cited by 5 publications

(5 citation statements)

References 18 publications

(29 reference statements)

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“… 40 A more recent systematic review came to similar results. 41 Many studies highlighted waiting time as predictive of reduced patient satisfaction. 42–47 Two systematic reviews reported that satisfaction rates were lower when expectations of patients regarding the decision were not met.…”

Section: Discussionmentioning

confidence: 99%

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Compliance and patient satisfaction with treatment settings recommended by the medical on-call service 116117 in Germany using computer-assisted structured initial assessment: a cross-sectional observational study accompanying the demand intervention

Schäfer

Menzel

Herrmann³

et al. 2023

BMJ Open

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ObjectivesIn order to reduce the use of emergency departments, computer-assisted initial assessment was implemented at the medical on-call service 116117. Our study assessed compliance and patient satisfaction.DesignCross-sectional observational postal survey.SettingMedical on-call service 116117 by eight Associations of Statutory Health Insurance Physicians in Germany.ParticipantsThe intervention was observed between January 2020 and March 2021. Minors and patients with invalid contact data were excluded. A random sample of eligible patients received standardised questionnaires by mail.Outcome measuresWe analysed associations of sociodemographic data, health status, previous service use, health literacy, and recommended settings with compliance and patient satisfaction by multivariable, multilevel logistic regression.InterventionsBased on symptoms and context factors, the computer software suggested service levels. Staff and patient discussed if higher levels were indicated, services were available and self-transport was possible. They then agreed on recommendations for treatment settings.ResultsOf 9473 contacted eligible patients, 1756 patients (18.5%) participated. Median age was 66 years (IQR=50–79), and 986 (59.0%) were women. At least one recommended setting was used by 1397 patients (85.4%). General practitioner (GP) practices were used by 143 patients (68.4%). Generally, better compliance was associated with lower depression levels (OR 1.59, 95% CI 1.17 to 2.17, p=0.003), fewer previous hospital stays (OR 2.02, 95% CI 1.27 to 3.23, p=0.003) and recommendations for any setting other than GP practices (OR 0.13, 95% CI 0.06 to 0.29, p<0001, to OR 0.37, 95% CI 0.19 to 0.72, p=0.003). A total of 606 patients (50.7%) were completely satisfied. Patient satisfaction was associated with higher age (OR 1.30, 95% CI 1.13 to 1.49, p<0.001), better self-rated health (OR 1.30, 95% CI 1.10 to 1.53, p=0.002), not having musculoskeletal disorders (OR 0.68, 95% CI 0.49 to 0.94, p=0.021), better health literacy (OR 0.69, 95% CI 0.54 to 0.89, p=0.005, and OR 0.49, 95% CI 0.36 to 0.67, p<0.001) and receiving no recommendation for GP practices (OR 0.61, 95% CI 0.43 to 0.87, p=0.006).ConclusionsMost patients were compliant and satisfied. Lowest compliance and satisfaction were found in GP practices, but nonetheless, two of three patients with respective recommendations were willing to use this setting.Trial registration numberGerman Clinical Trials Register DRKS00017014.

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Section: Discussionmentioning

confidence: 99%

“… 42–47 Two systematic reviews reported that satisfaction rates were lower when expectations of patients regarding the decision were not met. 41 48 49 Some studies saw patient satisfaction with the triage to be predictive of the compliance with the decision. 31 …”

Section: Discussionmentioning

confidence: 99%

Compliance and patient satisfaction with treatment settings recommended by the medical on-call service 116117 in Germany using computer-assisted structured initial assessment: a cross-sectional observational study accompanying the demand intervention

Schäfer

Menzel

Herrmann³

et al. 2023

BMJ Open

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“…14 See online supplemental appendix 1 for the PRISMA checklist. 15 Patient and public involvement No patient and public involvement (PPI) directly fed into the development or conduct of this review.…”

Section: Methodsmentioning

confidence: 99%

Service use, clinical outcomes and user experience associated with urgent care services that use telephone-based digital triage: a systematic review

et al. 2022

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ObjectiveTo evaluate service use, clinical outcomes and user experience related to telephone-based digital triage in urgent care.DesignSystematic review and narrative synthesis.Data sourcesMedline, Embase, CINAHL, Web of Science and Scopus were searched for literature published between 1 March 2000 and 1 April 2020.Eligibility criteria for selecting studiesStudies of any design investigating patterns of triage advice, wider service use, clinical outcomes and user experience relating to telephone based digital triage in urgent care.Data extraction and synthesisTwo reviewers extracted data and conducted quality assessments using the mixed methods appraisal tool. Narrative synthesis was used to analyse findings.ResultsThirty-one studies were included, with the majority being UK based; most investigated nurse-led digital triage (n=26). Eight evaluated the impact on wider healthcare service use following digital triage implementation, typically reporting reduction or no change in service use. Six investigated patient level service use, showing mixed findings relating to patients’ adherence with triage advice. Evaluation of clinical outcomes was limited. Four studies reported on hospitalisation rates of digitally triaged patients and highlighted potential triage errors where patients appeared to have not been given sufficiently high urgency advice. Overall, service users reported high levels of satisfaction, in studies of both clinician and non-clinician led digital triage, but with some dissatisfaction over the relevance and number of triage questions.ConclusionsFurther research is needed into patient level service use, including patients’ adherence with triage advice and how this influences subsequent use of services. Further evaluation of clinical outcomes using larger datasets and comparison of different digital triage systems is needed to explore consistency and safety. The safety and effectiveness of non-clinician led digital triage also needs evaluation. Such evidence should contribute to improvement of digital triage tools and service delivery.PROSPERO registration numberCRD42020178500.

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“…The literature has focused on certain performance aspects of telephone triage, such as experience of service [ 2 , 18 ], quality of communication [ 2 , 4 , 19–23 ], safety [ 2 , 5 , 19 , 24–29 ] or efficiency [ 5 , 19 , 20 ]. In addition, four literature reviews have been published [ 18 , 19 , 24 , 26 ]. Boggan et al.…”

Section: Introductionmentioning

confidence: 99%

“…Sexton et al. (2021) focused on evaluating telephone triage from the viewpoints of service user experience, service use, and clinical outcomes [ 18 ] describing the characteristics of patients accessing telephone triage services, the type of advice received, and the patient’s telephone triage experience. Gustafsson and Eriksson (2020) identified factors that indicate quality in telephone nursing.…”

Section: Introductionmentioning

confidence: 99%

Identifying performance indicators to measure overall performance of telephone triage – a scoping review

Vainio,

Soininen,

Castrén

et al. 2023

Scandinavian Journal of Primary Health Care

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Objective This article aims to summarize performance indicators used in telephone triage services research, and make recommendations for the selection of valid indicators to measure the performance of telephone triage. We describe what kind of frameworks, performance indicators, or variables have been used for evaluating telephone triage performance by systematically mapping the telephone triage performance measurement. The objective was to find measures for each Triple Aim dimension. Design A scoping review method was used following Joanna Briggs Institute guidelines. Using this method, we defined indicators to measure the performance of telephone triage. We used the Triple Aim framework to identify indicators to measure the overall performance of telephone triage. The Triple Aim framework consists of improving the patient experience of care, improving the health of populations, and reducing cost per capita. Setting The scoping review was performed using CINAHL, Medline, EBSCOhost, and PubMed electronic databases. The eligibility criterion was research published in English between 2015 and 2023. The inclusion focused on the use and performance of telephone triage services and system-focused studies. Results A total of 1098 papers were screened for inclusion, with 57 papers included in our review. We identified 13 performance indicators covering all Triple Aim dimensions: waiting times, access, patient satisfaction, the accuracy of triage decision, severity and urgency of the symptoms, triage response, patient compliance with the advice given, follow-up healthcare service use, and running costs of service. We didn’t find any earlier framework covering all Triple Aim dimensions properly. Conclusions Measuring the performance of telephone triage requires an extensive and comprehensive approach. We presented performance indicators that may be included in the framework for measuring the performance of telephone triage to support overall performance measurements of telephone triage.

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An evaluation of service user experience, clinical outcomes and service use associated with urgent care services that utilise telephone-based digital triage: a systematic review protocol

Cited by 5 publications

References 18 publications

Compliance and patient satisfaction with treatment settings recommended by the medical on-call service 116117 in Germany using computer-assisted structured initial assessment: a cross-sectional observational study accompanying the demand intervention

Compliance and patient satisfaction with treatment settings recommended by the medical on-call service 116117 in Germany using computer-assisted structured initial assessment: a cross-sectional observational study accompanying the demand intervention

Service use, clinical outcomes and user experience associated with urgent care services that use telephone-based digital triage: a systematic review

Identifying performance indicators to measure overall performance of telephone triage – a scoping review

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