Hi Cindy.
I work in a family practice and we do get the occasional walk-in, unscheduled patient who needs to be triaged.
I'm not aware of any written policy re: walk-in triages but I do think that's a good idea to have one.
When this situation comes up an announcement is made by the front desk check-in staff person " Triage Front Desk ". An RN responds.
If the patient appears stable enough they are brought into the first exam room and the nurse starts a " Telephone " encounter. In EPIC there is the option to change it to an " In person " encounter.
The RN quickly asks the patient about complaints and symptoms. Vital signs are taken if the situation warrants it. EVERYTHING is documented, just as you would do for a telephone triage encounter.
The outcome depends on the seriousness of the patient's symptoms. The possibilities include an office visit right away with a mid-level provider, a later same day appointment for a less severe situation, or calling for an ambulance if the patient needs a higher level of care.
If the patient has very serious symptoms the RN will consult with a physician of course.
We have a sign on the door stating that patients need to have an appointment but that doesn't stop patients from walking in without an appointment anyway.
I have even had someone walk in who wasn't even a patient in our practice. He was jogging by and was having chest pain. Of course we called 911 but luckily he also agreed to be enrolled as a patient while he was being assessed. This helped me as an RN and I was able to document the whole situation in EPIC. The patient ended up needing coronary stents and he came back for a follow up.
I would imagine that if the person is not an established patient and they don't agree to be enrolled as a new patient an incident report would need to be submitted as documentation of the situation.
I would like to hear what other nurses have to say about walk-in triages.
Original Message:
Sent: 8/14/2024 5:36:00 PM
From: Cindy Phan
Subject: Unscheduled walk-ins and Triage
Hello,
Does any institution have a policy on ambulatory walk-in triage? Ours is up for renewal and when I reviewed it, it shows that we should be using ESI, which is more for ER triage RNs. I couldn't find anything in the literature specific to triaging ambulatory walk in patients. Can anyone share with me your current process for a walk in patient who requires triaging?
Do you have an RN on site? What is the workflow? Do you have a policy for this?
Any feedback and guidance is appreciated!
Cindy
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Cindy Phan, MSN, RN
Clinical Nurse Educator- Ambulatory
UCI Health
Orange, CA
714-456-7131
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