Implementing remote triage in large health systems: A qualitative evidence synthesis

Abstract

Remote triage (RT) allows interprofessional teams (e.g., nurses and physicians) to assess patients and make clinical decisions remotely. RT use has developed widespread interest due to the COVID-19 pandemic, and has future potential to address the needs of a rapidly aging population, improve access to care, facilitate interprofessional team care, and ensure appropriate use of resources. However, despite rapid and increasing interest in implementation of RT, there is little research concerning practices for successful implementation. We conducted a systematic review and qualitative evidence synthesis of practices that impact the implementation of RT for adults seeking clinical care advice. We searched MEDLINE®, EMBASE, and CINAHL from inception through July 2018. We included 32 studies in this review. Our review identified four themes impacting the implementation of RT: characteristics of staff who use RT, influence of RT on staff, considerations in selecting RT tools, and environmental and contextual factors impacting RT. The findings of our systemic review underscore the need for a careful consideration of (a) organizational and stakeholder buy-in before launch, (b) physical and psychological workplace environment, (c) staff training and ongoing support, and (d) optimal metrics to assess the effectiveness and efficiency of implementation.

Exploring healthcare professionals’ perceptions of artificial intelligence: Piloting the Shinners Artificial Intelligence Perception tool

“…The promise that AI innovation will improve care delivery and reduce workload is attractive to organisations but there is doubt amongst healthcare organisations that the implementation of technology such as AI is viable, because of the investment that is required for infrastructure, training and policy development. [40][41][42] The socio-technical systems theory recommends that the individual, the organisation and the technology are given equal consideration before the introduction of new technology. 43 To help organisations maximise the benefit of this new technology, it is important to explore the experiences and perceptions of the healthcare workforce, so that barriers to implementing the technology can be identified, and training and education can be targeted to their needs.…”

Teletriagem de enfermagem no âmbito da saúde mental e psiquiátrica num serviço de saúde privado português

“…Por sua vez, Sands et al (2013) reconhecem que os serviços de teletriagem em Saúde Mental podem fornecer cuidados de saúde mental de emergência de alta qualidade via telefone para clientes em crise e emergência psiquiátrica. Neste sen�do, a implementação de estratégias remotas de intervenção que incluam uma cuidadosa avaliação do envolvimento organizacional e dos stakeholders antes do seu lançamento, do ambiente de trabalho �sico e psicológico, do treino e suporte con�nuo aos profissionais e das métricas para avaliar a eficácia e eficiência da teletriagem podem ser úteis e seguras para a orientação dos clientes para o nível adequado de encaminhamento (Lewinski et al, 2021). Adicionalmente, as estratégias remotas de teletriagem reduzem deslocações desnecessárias aos serviços de urgência (Frid et al, 2020), e ainda, permitem aos enfermeiros recorrerem a estes meios para recolher dados úteis à pesquisa, contribuindo para o conhecimento da disciplina e desenvolvimento da prá�ca (Rosinhas et al, 2021).…”

Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change?

“…The available evidence worldwide regarding the extent to which callers follow recommendations from telenurses and telephone advice nursing’s impact on healthcare visits is inconsistent 2 4 8 10. Context-specific factors such as healthcare organisation and workplace environment affect the external validity of findings 8 14. Identifying key policy lessons for any given telephone advice nursing service therefore requires it to be studied specifically.…”