Telephone triage training, consulting and expertise -- trusted by medical professionals since 1985
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Telephone Triage Expert Witness Services


ERROR IN TELEPHONE TRIAGE

“We don’t look for patterns of our recurrent mistakes or devise and refine potential solutions for them. But we could, and that is the ultimate point”.  Gawande, 2010

“Any mistake or failure in the diagnostic process can lead to a diagnosis that is wrong, missed or delayed. Inpatient diagnostic errors tend to be more lethal, however more diagnostic errors occur in ambulatory settings”. Groszkruger, 2015

At the risk of stating the obvious, telephone triage is risk-prone – due to extreme difficulties of assessing symptoms of patients we cannot see. Add to that, the propensity for human error due to cognitive bias when placed in ambiguous situation, decision fatigue and a time-driven work atmosphere that stresses efficiency over proficiency.

Ms. Wheeler has served as an expert witness for more than 35 medical malpractice cases since 1995.  Her experience includes the review and evaluation of medical malpractice cases for both plaintiffs and defendants.  In addition to recent experience as a front-line telephone triage practitioner, she has collaboratively developed telephone triage guidelines (protocols) in both paper and electronic format as well as telephone triage practice standards.  Ms. Wheeler authored the first training manual in telephone triage in 1993, and recently served as lead author on a review of the literature on Safety of Clinical and Non-Clinical Decision Makers in Telephone Triage published by the Journal of Telemedicine and Telecare in March,2015.

Ms. Wheeler has consulted on medical malpractice cases in a range of settings from Health Maintenance Organizations (HMO), hospitals and clinical call centers to medical group practices.  She has served the California State Board of Nursing on numerous occasions for cases involving nurse negligence.  She has consulted nationally and internationally, serving on a malpractice cases involving the Department of Managed Care of the State of California and the National Health Service (NHS) in the United Kingdom.

Ms. Wheeler has reviewed medical malpractice cases for a range of age groups — infant and child, school age, geriatric, adolescent and adult populations — as well as  flu-like symptoms, headache, backache and psychiatric complaints.   Ms. Wheeler has experience with document review, preparation of reports,  depositions, serving as an expert witness and providing court testimony.

In addition to serving as an expert witness, Ms. Wheeler’s expertise derives from front-line telepractice, research, authoring articles and books, speaking at conferences, protocol developer, and conference founder and developer.

Please see Ms.Wheeler’s Company and Professional milestones for details.

Listen to Ms. Wheeler’s recent presentation “To Err is Human, To Delay is Deadly” at the 2015 AAACN conference.

“Clinical Systems & Training to Help Clinicians Triage Patients to the Right Place at the Right Time for the Right Reason” TM