The impact of using computer decision-support software in primary care nurse-led telephone triage: Interactional dilemmas and conversational consequences

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

“…interpreters) and tools play in communication between nurses and patients. The topics covered by the articles ranged from phonemediated interactions (Butler et al, 2009;Leydon et al, 2013), and the role of interpreters (Estrada et al, 2015), to the influence of medical records (Rhodes et al, 2008) and computer-assisted technologies (Murdoch et al, 2015) in nurse-patient interaction. These studies suggest that technological mediation hinders rather than facilitates nurse-patient interaction.…”

“…External resources tend to interfere with the interactions and to lead to interactional misalignment (Jones, 2009;Murdoch et al, 2015;Rhodes et al, 2006). Further, the alternation from less to more asymmetrical interactions between nurses and patients is determined by nurses 'goals' , as nurses adopt patient-centred and nurse-centred communicative strategies depending on these goals .…”

“…Patient triage is an example of such interactions in which computer-mediation brings contingencies which enhance nurses control À this also applies to admissions and related interactions. Murdoch et al (2015) has documented how nurses strictly follow the items on their screen when triaging patients, and how this structures their conversation, at the expense of patient participation -sometimes leading to misunderstandings as a consequence. The redesign of computerassisted technology can be a straightforward way to solve such issues.…”

The future of primary care? Reflections on the Primary Care Workforce Commission report

“…Nuanced histories and examination cannot be reliably achieved through triage, with the result that pre-consultation segregation by presenting problem may put comprehensive and skilled assessment at risk, as well as limiting patients' choice of available healthcare provider and continuity of care. 11,12 This model leads to further questions about responsibility; the report is silent on the question of who bears ultimate responsibility for independent work delivered by the extended primary care team. On the wider objective of providing 'challenging and satisfying careers' it remains unclear how well prepared the existing or future GP workforce will be for a role that concentrates on clinical complexity and supervisory duties, while removing cases that can be readily diagnosed and resolved.…”

Remote clinical decision-making: a clinician’s definition

“…This non-face-to-face method of patient assessment is a key strategy for managing the rising demand in a range of financially and resource constrained public health services (Murdoch et al 2015) and within the UK ambulance services it is referred to as Telephone Triage or Hear & Treat; as opposed to the traditional framework of See & Treat. Neither the title of Telephone Triage or Hear & Treat however adequately reflect the diverse roles of health care professionals within 999 ambulance service clinical hubs.…”