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Telephone Triage Consulting & Research

Citations: Safety of Clinical & Non-Clinical Decision Makers in Telephone Triage” (2015, Wheeler et al)

International Feedback

Telephone Triage nurses in Dublin, Ireland:  “Your article — Telephone Triage: Solutions for Recurrent Errors in Primary Care, Urgent Care & ED— was very useful as it addresses all the aspects of telephone triage. I work in the maternity emergency department and our small team receive over 40 calls/day. There is no designated service and this is what I am looking at.  

Your articles are useful to see the pitfalls and how they might be overcome. There is very little research in relation to maternity care but much of it is transferrable. Documentation is a huge issue – we are looking at recording calls but cost might be an issue. Thanks again for sharing your research.”  Nurse at a Maternity Hospital, Dublin, Ireland.

Whether you need specialized training,  legal nurse consulting, telehealth conference development, or guideline development or refinement, Ms. Wheeler brings expertise, professionalism, a passion for excellence and “real world” solutions to every telephone triage consultation project. Review Ms. Wheeler’s recent presentation “To Err is Human, To Delay is Deadly”  2015 AAACN conference. 

Guideline & Protocol Developer: Ms. Wheeler was the first telephone triage expert to develop age-specific guidelines that also addressed the needs of high-risk, low-income, low literacy populations. In addition, Ms Wheeler developed the first 5-level telephone triage guidelines in 1995, during which period she also worked with two software companies to develop software versions of the guidelines.

The extraordinary challenge of making safe decisions in telephone triage does not appear to have been met by current CDSS.  It requires electronic guidelines that reduce human error and support metacognition (knowing when & how to use certain strategies for solving a problem).  Ms. Wheeler has developed a prototype for a Universal Guideline to address these challenges.  She seeks to collaborate with current software and EMR (EHR) companies to refine their existing Clinical Decision Support Systems.

“We’ve learned that automation does not eliminate errors. Rather, it changes the nature of the errors that are made, and it makes possible new kinds of errors. The bottom line is this: Systems that integrate the best of human abilities and technology are the safest for all concerned”.  Captain Sully Sullenberger

Two recent books address quality and safety in healthcare with implications for telephone triage safety:   The Digital Doctor:  Hope, Hype and Harm at the Dawn of Medicine’s Computer Age, by Robert Wachter, MD, and The Checklist Manifesto:  How to Get Things Right by Atul Gawande, MD.