Telephone Medicine: Triage and Training for Primary Care / Edition 2

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The first link in the chain of communication between patient and primary care provider is the telephone. No matter which side of the phone you are on healthcare provider or patient Telephone Medicine: Triage and Training for Primary Care offers you valuable information on adult and pediatric symptoms that require medical attention.This totally updated, practical handbook will be invaluable to you, especially if you are a:

Triage nurse, Nurse practitioner, Physician assistant, Resident, Medical student, Internist, Pediatrician, Family physician, Medical assistant, Parent, Teacher, Childcare worker

As a healthcare provider, do you know what to do first when a patient calls? You'll get facts on:

  • Organizing the telephone system to support the practice
  • Prioritizing when an appointment is needed -- using time-tested protocols for the most common calls encountered in a primary care practice
  • Satisfying patients on the telephone and creating a postivie image for the practice

If you or someone in your family needs medical attention, do you know what to tell your healthcare provider? You'll get facts on:

  • Assessing an injury or illness and deciding whether to seek medical attention
  • Watching for changes in symptoms
  • Treating injuries and illness at home, when appropriate
  • Uses Telephone Decision Guidelines, a rapid reference of questions for assessing the urgency of most common telephone calls
  • Written at an appropriate level for the medical office assistant and organized by complaint
  • Chapters on individual complaints cover adults and children and provide staff with essential background information and a list of the questions to ask in order to determine the urgency of the patient's condition; covers 19 pediatric symptoms and 33 adult symptoms
  • Includes sample cases to train and evaluate personnel
  • Offers guidance on risk management for physician and staff
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Editorial Reviews

Doody's Review Service
Reviewer: Donna L Cain, BSN, MSN (Bureau of Medicine and Surgery)
Description: This book provides practical information for evaluating current telephone medicine systems, easy to follow symptom-based triage algorithms, and recommendations for training the telephone staff. The first edition was published in 1982, revised in 1990 and was directed toward pediatric patients only.
Purpose: The purpose is to provide practical, useful, and accessible information to practicing clinicians and their staff. This book addresses the need to improve telephone care through an interconnected triad of telephone medicine, triage, and training. Telephone medicine accounts for a significant percentage of patient contacts in primary care. Therefore, this book can play an important role in the primary care setting. The book meets the authors objectives.
Audience: According to the author, the book is written for triage nurses, nurse practitioners, physician assistants, medical students, pediatricians, family physicians, internists and house staff. In my opinion, this book is written more for the triage provider/nurse, the patient educator, the clinic manager, and the performance improvement coordinator. The author's biography provides credible documentation of his authority in the subject matter.
Features: The book is divided into three main sections. The first addresses the telephone system; the role of the telephone, establishing a system, the medicolegal issues, skills required, and appropriate use for patient care. The second address pediatric and adult triage. It contains excellent, easy to follow algorithms for patient concerns. The third section address training the staff and evaluation of the entire system. This section also provides suggestions for patient education of telephone medicine. The table of contents is an alphabetized listing of symptoms for children and adults that provides fast access to topics, a time-saving feature for the triage provider.
Assessment: This is a comprehensive guide to telephone medicine. It provides helpful information for starting a new, or evaluating a current telephone medicine system. It contains easy to follow triage algorithms for children and adults, a staff and patient training section, and an evaluation process. The first edition focused on the triage of pediatric patients. Most telephone medicine references emphasize patient triage and not the adminsistrative issues that are necessary for a successful system. This edition is a valuable tool for all primary care providers, support staff, and clinic managers.
Katz (Harvard Medical School) provides a practical guide to effective telephone contact between practitioners and patients. The author considers the role of the telephone in medical care, the organization of an office telephone care system, the training and evaluation of staff in effective telephone skills, and medicolegal issues in telephone medicine. Concise guidelines for telephone triage of 22 common symptoms in children and 33 common symptoms in adults are also included. Directed to practicing physicians and their staff, this book would also be accessible to parents, childcare providers and teachers. Annotation c. Book News, Inc., Portland, OR (

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780803604353
  • Publisher: F. A. Davis Company
  • Publication date: 3/28/2001
  • Edition description: REV
  • Edition number: 2
  • Pages: 279
  • Product dimensions: 7.06 (w) x 9.99 (h) x 0.47 (d)

Table of Contents

SECTION 1: The Telephone in the Primary Health Care Practice
1. The Role of the Telephone in Medical Care-An Overview
2. Organizing an Office Telephone Care System
3. Medicolegal Issues in Telephone Medicine
SECTION 2: Telephone Skills in Primary Health Care
4.  The Art of Telephone Medicine
5. The Medical History
6. Prescribing Medication over the Telephone
7. How to Use the Triage Chapters of this Book
SECTION 3: Telephone Triage: Symptoms in Children
8. Abdominal Pain
9. Animal Bites
10. Asthma
11. Burns and Sunburn
12. Colds
13. Constipation
14. Croup
15. Diarrhea
16. Earache
17. Eye Infection and Inflammation
18. Fever
19. Headache
20. Head Injury
21. Insect Bites and Stings
22. Nosebleed
23. Poisoning
24. Rashes
25. Sore Throat
26. Strains and Sprains
27. Urinary Burning and Frequency
28. Vomiting
29. Wounds
SECTION 4: Telephone Triage: Symptoms in Adults
30. Abdominal Pain
31. Allergic Reactions and Anaphylaxis
32. Back Pain
33. Breast Pain in Nursing Mothers
34. Burns
35. Chest Pain
36. Colds and Flu
37. Constipation
38. Cough
39. Diarrhea
40. Ear Pain
41. Eye Pain and Foreign Bodies
42. Fainting
43. Fever
44. Frostbite
45. Headache
46. Head Injury
47. Menstrual Cycle Problems: Amenorrhea and Oligomenorrhea
48. Menstrual Pain
49. Neck Pain
50. Nosebleed
51. Rashes and Infections
52. Shortness of Breath
53. Sore Throat
54. Strains and Sprains
55. Sunburn
56. Urinary Tract Infections
57. Vaginal Bleeding
58. Vaginal Discharge
59. Visual Disturbance
60. Vomiting and Nausea
61. Wheezing
62. Wounds
SECTION 5: Training and Evaluating Telephone Staff
63. A Four-Step Approach to Improving Telephone Service
64. Case Studies for Role Playing Appendices: A Patient's Guide to Effective Use of the Telephone Suggestions for Further Study
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Interviews & Essays

Author Essay
How to Improve the Quality of Care and Service of Telephone Medicine

While there have been many technological advances in the 125 years since the telephone was invented, one thing has not changed. The phone remains the first link in the chain of communication between patient and clinician. In fact, it started that way when Bell summoned Watson with those immortal words, "Watson -- come here, I want you!" The inventor had accidentally spilled sulfuric acid on himself.

The phone is a double-edged sword. Clinicians can't live without it, but the phone has become the No. 1 complaint from patients about service -- "I can never get through" -- and a leading cause of staff burnout in the physician's office. The volume of calls has become overwhelming. A better system is needed.

I first became interested in the important role of the telephone in medical care when I was asked to start the Johns Hopkins Health Plan in Columbia, Maryland. One of the first problems in our medical offices was with the telephone, and our patients let us know.

Necessity became the mother of invention. Since there were so few resources available, I was forced to develop our own protocols and ways to improve the system of managing phone calls. This led to my first edition, which was published in l982. My original preface stated, "Managing the telephone represents one of the great challenges in ambulatory medical care." Few would disagree that this is still true.

Evaluating a patient over the telephone is much more difficult than face to face. It is both an art and a science. This new second edition of Telephone Medicine: Triage and Training for Primary Care is written for all nursing and physician assistant triage staff; primary care clinicians in family practice, internal medicine, and pediatrics; and medical students and medical support staff.

The purpose of the book is to improve both the quality of telephone care and service. The book provides time-tested protocols for responding to the most common phone calls received in both pediatric and adult primary care practice. It is intended to help triage staff make timely decisions in recognizing emergencies, as well as to safely guide appropriate utilization of office visits.

A unique method of graphically indicating the urgency of an office or clinic visit is included -- along with sound home management advice for both adults and children when an office visit is not needed. A section is also devoted to guidelines for prescribing medication over the phone.

Above all, the book is practical, intended for busy office and clinic staff. In addition to triage, chapters address important telephone medicine subjects like the art of speaking with patients and how telephone staff present the image of the practice; reducing medical liability; measuring and improving patient satisfaction; requirements for a high quality call center; a method for training and evaluating telephone staff; and guidelines for how patients, as key members of the health care team, can use the phone more effectively. (Harvey P. Katz, M.D.)

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