Open Forum

Good afternoon,

I am looking to connect with anyone who currently utilizes a nurse triage line for specialty practices such as surgery, oncology, orthopedics, neurology and OBGYN. 
I know Schmitt Thompson protocols are geared more towards Primary care, so I am looking for ways to incorporate these protocols or how you chose to create your own specialty specific protocols to overcome that barrier.

Have a great day!
.

------------------------------
Amanda Rohrbaugh RN, BSN
Clinical Manager
WellSpan Health
Marietta PA
(717)799-1804
------------------------------

Amanda, 

Nice to meet you! We use the Schmitt Thompson adult and pediatric protocols for over 70 different primary care and medical specialty offices here in Central PA. Our specialties include OB/GYN, Endo, Rheum, Cardiology, and urology at this time. We find that most of the calls that come in from those sites fit the primary care protocols already in place. The biggest part that is not well covered it post surgical care and in those cases we triage to the best of our ability and then refer to the on call surgeon for next steps when needed. 
I am happy to chat anytime. Would also love to hear what others do in these cases as we continue to expand in the specialty world as well. 

holmesnl@upmc.edu

------------------------------
Nicole Holmes RN
Nurse Manager for Clincal Call Services
UPMC Pinnacle
NewBloomfield PA
717-988-9666
------------------------------

Hi Nicole and Amanda, 

We will also be using the EPIC Nurse Triage protocols built into EPIC. Although many specialty nurses will say they don't get triage calls or the protocols don't fit, that is not an accurate statement. The most important aspect of triage is recognizing the urgency, the nurse must rule out that the post op patient is not having a PE or something equally as catastrophic, the protocols are designed to trigger appropriate questions so these symptoms don't get overlooked. 

Susanna

------------------------------
Susanna Gadsby MSN, MBA, AMB-BC, NPD-BC
Clinical Educator, Ambulatory
AAACN Certified
Nursing Professional Development Specialist
susanna.m.gadsby@hitchcock.org
------------------------------

Original Message:
Sent: 11-18-2022 13:07
From: Nicole Holmes
Subject: Specialty Practice Telephone Triage

Amanda, 

Nice to meet you! We use the Schmitt Thompson adult and pediatric protocols for over 70 different primary care and medical specialty offices here in Central PA. Our specialties include OB/GYN, Endo, Rheum, Cardiology, and urology at this time. We find that most of the calls that come in from those sites fit the primary care protocols already in place. The biggest part that is not well covered it post surgical care and in those cases we triage to the best of our ability and then refer to the on call surgeon for next steps when needed. 
I am happy to chat anytime. Would also love to hear what others do in these cases as we continue to expand in the specialty world as well. 

holmesnl@upmc.edu

------------------------------
Nicole Holmes RN
Nurse Manager for Clincal Call Services
UPMC Pinnacle
NewBloomfield PA
717-988-9666
------------------------------

Hello Susanna,
I would love to see a protocol you have developed. We have group of triage nurses for Hepatology. We are in the process of developing and implementing protocols and updating our standards of practice. Trying to keep this nurse driven and not physician driven.
Any insight will be most helpful.
Thanks,
Kelly Cunningham RN
Vanderbilt Hepatology/Liver and Kidney Transplant Center
kelly.l.cunningham@vumc.org

------------------------------
Kelly Cunningham
RN
Vanderbilt University Medical Center
Murfreesboro TN
(920)296-3452
------------------------------

Original Message:
Sent: 11-21-2022 07:54
From: Susanna Gadsby
Subject: Specialty Practice Telephone Triage

Hi Nicole and Amanda, 

We will also be using the EPIC Nurse Triage protocols built into EPIC. Although many specialty nurses will say they don't get triage calls or the protocols don't fit, that is not an accurate statement. The most important aspect of triage is recognizing the urgency, the nurse must rule out that the post op patient is not having a PE or something equally as catastrophic, the protocols are designed to trigger appropriate questions so these symptoms don't get overlooked. 

Susanna

------------------------------
Susanna Gadsby MSN, MBA, AMB-BC, NPD-BC
Clinical Educator, Ambulatory
AAACN Certified
Nursing Professional Development Specialist
susanna.m.gadsby@hitchcock.org
------------------------------


Original Message:
Sent: 11-18-2022 13:07
From: Nicole Holmes
Subject: Specialty Practice Telephone Triage

Amanda, 

Nice to meet you! We use the Schmitt Thompson adult and pediatric protocols for over 70 different primary care and medical specialty offices here in Central PA. Our specialties include OB/GYN, Endo, Rheum, Cardiology, and urology at this time. We find that most of the calls that come in from those sites fit the primary care protocols already in place. The biggest part that is not well covered it post surgical care and in those cases we triage to the best of our ability and then refer to the on call surgeon for next steps when needed. 
I am happy to chat anytime. Would also love to hear what others do in these cases as we continue to expand in the specialty world as well. 

holmesnl@upmc.edu

------------------------------
Nicole Holmes RN
Nurse Manager for Clincal Call Services
UPMC Pinnacle
NewBloomfield PA
717-988-9666

Hi Susanna and Kelly (fellow Vandy employee),
If you are willing to share your protocol, I would love to see it as well.
We are currently looking to enhance our telephone triage education and process.

Suzanne.s.duckworth@vumc.org


------------------------------
Suzanne Duckworth BSN RN
Nursing Educator
Vanderbilt Medical Center
Nashville TN
(601)606-4588
------------------------------

Original Message:
Sent: 11-21-2022 15:09
From: Kelly Cunningham
Subject: Specialty Practice Telephone Triage

Hello Susanna,
I would love to see a protocol you have developed. We have group of triage nurses for Hepatology. We are in the process of developing and implementing protocols and updating our standards of practice. Trying to keep this nurse driven and not physician driven.
Any insight will be most helpful.
Thanks,
Kelly Cunningham RN
Vanderbilt Hepatology/Liver and Kidney Transplant Center
kelly.l.cunningham@vumc.org

------------------------------
Kelly Cunningham
RN
Vanderbilt University Medical Center
Murfreesboro TN
(920)296-3452
------------------------------


Original Message:
Sent: 11-21-2022 07:54
From: Susanna Gadsby
Subject: Specialty Practice Telephone Triage

Hi Nicole and Amanda, 

We will also be using the EPIC Nurse Triage protocols built into EPIC. Although many specialty nurses will say they don't get triage calls or the protocols don't fit, that is not an accurate statement. The most important aspect of triage is recognizing the urgency, the nurse must rule out that the post op patient is not having a PE or something equally as catastrophic, the protocols are designed to trigger appropriate questions so these symptoms don't get overlooked. 

Susanna

------------------------------
Susanna Gadsby MSN, MBA, AMB-BC, NPD-BC
Clinical Educator, Ambulatory
AAACN Certified
Nursing Professional Development Specialist
susanna.m.gadsby@hitchcock.org


Original Message:
Sent: 11-18-2022 13:07
From: Nicole Holmes
Subject: Specialty Practice Telephone Triage

Amanda, 

Nice to meet you! We use the Schmitt Thompson adult and pediatric protocols for over 70 different primary care and medical specialty offices here in Central PA. Our specialties include OB/GYN, Endo, Rheum, Cardiology, and urology at this time. We find that most of the calls that come in from those sites fit the primary care protocols already in place. The biggest part that is not well covered it post surgical care and in those cases we triage to the best of our ability and then refer to the on call surgeon for next steps when needed. 
I am happy to chat anytime. Would also love to hear what others do in these cases as we continue to expand in the specialty world as well. 

holmesnl@upmc.edu

------------------------------
Nicole Holmes RN
Nurse Manager for Clincal Call Services
UPMC Pinnacle
NewBloomfield PA
717-988-9666

I'm also interested in seeing what protocols organizations have developed for cardiology, general surgery, cardiothoracic and vascular surgery, endocrinology, and colo-rectal surgery. Happy to collaborate, too.

------------------------------
Kellie Renich RN
Staff Development RN
Johns Hopkins Community Physicians
Baltimore MD
301-873-1072
------------------------------

Original Message:
Sent: 11-21-2022 15:09
From: Kelly Cunningham
Subject: Specialty Practice Telephone Triage

Hello Susanna,
I would love to see a protocol you have developed. We have group of triage nurses for Hepatology. We are in the process of developing and implementing protocols and updating our standards of practice. Trying to keep this nurse driven and not physician driven.
Any insight will be most helpful.
Thanks,
Kelly Cunningham RN
Vanderbilt Hepatology/Liver and Kidney Transplant Center
kelly.l.cunningham@vumc.org

------------------------------
Kelly Cunningham
RN
Vanderbilt University Medical Center
Murfreesboro TN
(920)296-3452
------------------------------


Original Message:
Sent: 11-21-2022 07:54
From: Susanna Gadsby
Subject: Specialty Practice Telephone Triage

Hi Nicole and Amanda, 

We will also be using the EPIC Nurse Triage protocols built into EPIC. Although many specialty nurses will say they don't get triage calls or the protocols don't fit, that is not an accurate statement. The most important aspect of triage is recognizing the urgency, the nurse must rule out that the post op patient is not having a PE or something equally as catastrophic, the protocols are designed to trigger appropriate questions so these symptoms don't get overlooked. 

Susanna

------------------------------
Susanna Gadsby MSN, MBA, AMB-BC, NPD-BC
Clinical Educator, Ambulatory
AAACN Certified
Nursing Professional Development Specialist
susanna.m.gadsby@hitchcock.org


Original Message:
Sent: 11-18-2022 13:07
From: Nicole Holmes
Subject: Specialty Practice Telephone Triage

Amanda, 

Nice to meet you! We use the Schmitt Thompson adult and pediatric protocols for over 70 different primary care and medical specialty offices here in Central PA. Our specialties include OB/GYN, Endo, Rheum, Cardiology, and urology at this time. We find that most of the calls that come in from those sites fit the primary care protocols already in place. The biggest part that is not well covered it post surgical care and in those cases we triage to the best of our ability and then refer to the on call surgeon for next steps when needed. 
I am happy to chat anytime. Would also love to hear what others do in these cases as we continue to expand in the specialty world as well. 

holmesnl@upmc.edu

------------------------------
Nicole Holmes RN
Nurse Manager for Clincal Call Services
UPMC Pinnacle
NewBloomfield PA
717-988-9666

Hello, all:
Whenever one of our specialty clinic nurses feel there is a need for a specialty protocol, they first look at what we currently have in Epic (we use Schmitt-Thompson protocols).  They then add/remove symptoms as appropriate for their specialty.  We have had great success with OB/GYN and some procedural areas, and we are currently adding oncology symptoms to the existing protocols in Epic.  An example is Hand and Wrist Pain: we have incorporated the symptoms for peripheral neuropathy; Other paresthesias have also been added into the appropriate protocols (Foot Pain, Toe Pain, Finger Pain).  Once the specialty medical director approves the additions, our Ambulatory Telephone Protocol Committee reviews and approves.  It is extremely important to have buy-in and approval from all stakeholders, especially in a health system.

I am able to review our procedure in more detail should anyone want additional information.

------------------------------
Michaelene Wolff, BSN, RN, OCN, AMB-BC
Coordinator, Clinical Programs
Chair, Ambulatory Telephone Protocol Committee
University of Colorado Hospital
Aurora CO
------------------------------