The effectiveness of nurse-led outpatient referral triage decision making in pediatric otolaryngology. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Hong, Paul; Ritchie, Krista; Beaton-Campbell, Cathy; Cavanagh, Lynn; Belyea, James; Corsten, Gerard
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 79:Issue 4(2015:Apr.)
• Page Start: 576
• Page End: 578
• Publication Date: 2015-04
• Subjects: Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2015.01.031
• Languages: English
• ISSNs: 0165-5876

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Objectives</title> <p id="spar0005">To assess the effectiveness of nurse-led triage of outpatient referrals in an academic pediatric otolaryngology practice.</p> </sec> <sec> <title id="sect0015">Methods</title> <p id="spar0010">Three hundred consecutive outpatient referrals were reviewed and triaged by two otolaryngology registered nurses and two attending pediatric otolaryngologists. The nurses received triage training. The referrals were triaged as 'routine' (to be seen within 2–3 months), 'semi-urgent' (to be seen within 6 weeks), or 'urgent' (to be seen within 2 weeks). Weighted Kappa statistics (correcting for chance agreement) were performed to assess for the degree of agreement. After the consultation visits, patient records were reviewed to determine whether any referrals had been inappropriately triaged by the nurses.</p> </sec> <sec> <title id="sect0020">Results</title> <p id="spar0015">Overall, there was substantial agreement between all raters. Specifically, weighted Kappa statistics were as follows: surgeon 1, nurse 1: 0.708; surgeon 1, nurse 2: 0.670; surgeon 2, nurse 1: 0.762; surgeon 2, nurse 2: 0.647; nurse 1, nurse 2: 0.756; and surgeon 1, surgeon 2: 0.784. Review of patient charts after consultation showed that no referrals were deemed to be inappropriately triaged and no urgent cases had been missed.</p> </sec> <sec> <title id="sect0025">Conclusions</title> <p id="spar0020">Our model of nurse-led triage of outpatient referrals was found to be effective and safe. Similar systems may be considered in other areas of medicine as a viable and acceptable alternative to the traditional physician-led triage practice.</p> </sec> </abstract>