Nurse-led triage of otolaryngology out-patient referrals: an acceptable alternative?

Hathorn, Iain; Barnes, Martyn; Mountain, Rocky

doi:10.1017/s0022215109990399

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…Moreover, the level of agreement observed in the current study was better than previous studies in primary care and in the adult surgical setting, where inter-rater agreement was mostly considered 'fair' to 'moderate' [3,6]. Small variability also existed between the two physicians in our study (0.784), which was in keeping with previous studies [6]. This is Table 1 Number of referrals triaged in each category by different raters.…”

Section: Discussionsupporting

confidence: 85%

“…This is demonstrated, for instance, by the expansion of the number of nurse practitioners in North America [1]. Furthermore, nurses have assumed leadership roles [12] and have taken over duties traditionally performed by physicians [2,6]. One such role is the triaging of outpatient referrals in healthcare settings.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, physician-led triage process may occur on an adhoc basis, while the nurses can act in a more timely manner. In turn, such a system may reduce the workload of physicians, potentially allowing them to devote more time to performing other clinical or academic duties [6]. As well, there may be cost containment and improved efficiency since physician time is more costly to the healthcare system than that of nurses.…”

Section: Ratersmentioning

confidence: 99%

“…Specifically, nurse-led triage has been reported to be safe and effective in primary care [3], acute medical admissions [4], and in some surgical specialities [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Some of these include telephone triage [3], computer-aided triage [7], and internet based e-mail triage services [8]. Yet, most subspecialty surgical centers still use the traditional triage system where the consulting physicians perform the triage duties [6].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The effectiveness of nurse-led outpatient referral triage decision making in pediatric otolaryngology

Hong

Ritchie

Beaton-Campbell

et al. 2015

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Ratersmentioning

confidence: 99%

“…Specifically, nurse-led triage has been reported to be safe and effective in primary care [3], acute medical admissions [4], and in some surgical specialities [5,6].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The effectiveness of nurse-led outpatient referral triage decision making in pediatric otolaryngology

Hong

Ritchie

Beaton-Campbell

et al. 2015

International Journal of Pediatric Otorhinolaryngology

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Patient safety in otolaryngology: a descriptive review

Danino

Muzaffar

Metcalfe

et al. 2016

Eur Arch Otorhinolaryngol

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Human evaluation and judgement may include errors that can have disastrous results. Within medicine and healthcare there has been slow progress towards major changes in safety. Healthcare lags behind other specialised industries, such as aviation and nuclear power, where there have been significant improvements in overall safety, especially in reducing risk of errors. Following several high profile cases in the USA during the 1990s, a report titled "To Err Is Human: Building a Safer Health System" was published. The report extrapolated that in the USA approximately 50,000 to 100,000 patients may die each year as a result of medical errors. Traditionally otolaryngology has always been regarded as a "safe specialty". A study in the USA in 2004 inferred that there may be 2600 cases of major morbidity and 165 deaths within the specialty. MEDLINE via PubMed interface was searched for English language articles published between 2000 and 2012. Each combined two or three of the keywords noted earlier. Limitations are related to several generic topics within patient safety in otolaryngology. Other areas covered have been current relevant topics due to recent interest or new advances in technology. There has been a heightened awareness within the healthcare community of patient safety; it has become a major priority. Focus has shifted from apportioning blame to prevention of the errors and implementation of patient safety mechanisms in healthcare delivery. Type of Errors can be divided into errors due to action and errors due to knowledge or planning. In healthcare there are several factors that may influence adverse events and patient safety. Although technology may improve patient safety, it also introduces new sources of error. The ability to work with people allows for the increase in safety netting. Team working has been shown to have a beneficial effect on patient safety. Any field of work involving human decision-making will always have a risk of error. Within Otolaryngology, although patient safety has evolved along similar themes as other surgical specialties; there are several specific high-risk areas. Medical error is a common problem and its human cost is of immense importance. Steps to reduce such errors require the identification of high-risk practice within a complex healthcare system. The commitment to patient safety and quality improvement in medicine depend on personal responsibility and professional accountability.

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