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  • 1.  Schmidtt-Thompson Clinical Content/Triage Nurses

    Posted 3 days ago

    Good afternoon!

    We are on the Epic journey and having discussions in our ambulatory environment about incorporating Telephone Triage Nurses into our Primary Care structure which would be new for our organization. I am working with the Epic team and had been asked to do some research around this.  I was introduced to the Schmidtt-Thompson Clinical Content by our Epic team and saw a brief demonstration.  I did search and read through several prior conversations around this product in these blogs and did not see any real concerns mentioned.  Does anyone have any more recent concerns about this product?  It seems well-researched, evidenced-based and solid in its content.  Also, the question was brought to me about using the "no or negative" functionality".  It seems safe but would value any feedback around that as well.

    Also, for those that use telephone triage nurses, do your triage nurses cover just the primary care offices?  Or do they cover specialty offices as well?  How do you determine the number of FTEs needed?  We are considering a 1-tier process - calls being routed directly to or answered directly by the triage nurses.  Considering starting with the Primary Care backline calls that are currently not being answered timely but instead most often waiting for the providers to respond.

    I value any feedback around any of these topics.  Thank you in advance for your time and advice.  I know many of you have had telephone triage nurses for years.



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    Karol Edwards MHA, RN, NE-BC
    CNO, Ambulatory Services
    MedStar Health
    Columbia, MD
    410-746-2430
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  • 2.  RE: Schmidtt-Thompson Clinical Content/Triage Nurses

    Posted 2 days ago
    Hello Karol!
    Our primary care network has been utilizing the EPIC triage protocols for several years. Prior to this, we relied on the Schmitt‑Thompson triage content in a manual format, so the transition to an electronic system was a welcomed improvement. The EPIC protocol content is evidence‑based, and we have confidence in its continued relevance because it undergoes quarterly review. Any updates are promptly communicated to our IT department to ensure our system remains current. We have recently begun expanding the EPIC triage protocols into our specialty practices. As part of this rollout, several specialty providers expressed concerns that the protocols are primarily designed for a primary care context. As a result, some of the recommended dispositions may not align with the clinical expectations or preferred workflows within their specialty. It has required provider education regarding the triage nurse's  ability to override dispositions based on nursing judgement or provider direction, with the caveat that there must be a comment entered when this occurs. As the specialty roll out is in its infancy, I cannot identify any other hiccups that have occurred. 
    I think the one noted topic that has required across the board re-education for all of ambulatory is that these are decision support tools that do not override nursing judgement.
    Hope this is helpful!
     

    Melissa Taylor, MSN, RN, AMB-BC, NE-BC

    Director of Ambulatory Nursing

     Primary Care & Ambulatory Care Coordination

    Elliot Clinical Services

    Phone: 603-663-3503

    Email: mtaylor@elliot-hs.org

     

     

    This document contains information constituting records and/or testimony relating to activities of a quality assurance committee and is therefore protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding, pursuant to NH RSA 151:13-a and/or RSA 329:29-a.

     

     






  • 3.  RE: Schmidtt-Thompson Clinical Content/Triage Nurses

    Posted 2 days ago

    Hello Karol -

    We provide telephone triage for both primary and specialty services and utilize the Schmitt-Thompson triage system.  Our practices have individual directives that serve as guidance for our team, as well.  We find Schmitt-Thompson triage protocols to be helpful and it based on best practices. The negative or "no" functionality serves are documentation that the protocol question has been asked/reviewed. We've used ST for a while now and have no concerns at this point.  They do updates and send out updates to protocols after their review. 

    Determining FTE's can be challenging at times and I would also like to know if there is a golden standard for determining how many FTE's are needed.  We provide mostly after-hours triage coverage and there are certain time/ranges that are busier than others.  I typically check the "missed calls" stats which indicate whether we are properly staffed or not. 

    We currently have over 130 subscribers with a staff of 15-16 nurses (some are part time/supplemental). 

    I hope this information is helpful to you!  Please let me know if I can be of assistance to you!

    Wendy Bowman 

     



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    Wendy Bowman, MA, BSN, RN, COHN-S
    Clinical Manager
    ECU Health Nurse Advice Line
    Greenville, NC
    252-847-7850
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  • 4.  RE: Schmidtt-Thompson Clinical Content/Triage Nurses

    Posted 2 days ago

    Thank you, Wendy!  Appreciate your response.  Very helpful!

     

    Karol Edwards MHA, RN NE-BC

    Vice President and Chief Nursing Officer

    MedStar Ambulatory Services

    MedStar Medical Group

     

    MedStar Health

    10980 Grantchester Place

    Columbia, MD  21044

    Cell:  410-746-2430

    Karol.edwards@medstar.net

     

     

     




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