Original papers Telephone triage of acute illness by a practice nurse in general practice: outcomes of care

Background. Telephone working is an increasingly impor-tant way of managing general practice workload, particular-ly out of hours. The role of telephone triage, however, in managing acute consultations during the day has not been adequately researched. Aim. To determine the impact of telephone triage, conduct-ed by a practice nurse, on the management of same day consultations in a general practice. Method. A general practice of 11 300 patients in South Tyneside collected prospective telephone and surgery con-sultation data over three months. Patient satisfaction, for those who had received only telephone advice, was mea-sured using a postal questionnaire. Four outcomes were measured: changes in doctor and nurse workload; repeat consultations with the same problem; prescriptions issued; and patient satisfaction with the service. Resufts. In three months, 1263 consultations were record-ed. Doctor workload fell by 54%, from 1522 to 664 consulta-tions, compared with the previous three months. A total of 325 (26%) telephone requests to see the doctor were man-aged by the nurse on the telephone without them visiting the surgery. Also, 273 (21%) patients saw the nurse in the surgery, 565 (45%) saw the doctor in the surgery, and 99 (8%) saw the doctor and the nurse in the surgery. The response rate to the postal questionnaire was 192/271 (71%); 154 (88%) were satisfied with nurse telephone advice. Conclusions. Telephone triage, by a practice nurse, of patients who wish to see the doctor on the same day, reduced doctor workload. This was a service that patients liked