Congress Abstracts 2006

31

A PATIENT CENTERED WEB-BASED APPLICATION FOR ONCOLOGY NURSING TELEPHONE TRIAGE. Virginia Martin, RN, MSN, AOCN^®, Tracy Christie-McLain, MBA, Mark Siemon, Carolmarie Mahoney, and Michael Bookman, MD, Fox Chase Cancer Center, Philadelphia, PA.

Telephone triage is the process of ensuring safe and effective disposition of patient concerns or problems by telephone. Documentation of each telephone encounter is required for medical and legal reasons. Developing a system for documentation and improved continuity of telephone interactions was identified as an area for improvement.

An NCI designated comprehensive cancer center had a call center for medical and surgical oncology patients to utilize seven days a week, 24 hours a day and report concerns to an oncology nurse. Historically, this documentation of telephone nurse encounters was in a written format that after completion was sent to medical records for filing in the chart. The information from that call could theoretically be retrieved but often was not and when recovered not current enough to be helpful. A group was convened to improve the process of documentation and consider an electronic system.

A major goal was to provide a secure two-way messaging system in which the message could be accessed in real-time, ensuring a faster response time to patient concerns. The group members included: oncology nurses, a system analyst, physician, administrator, and web programmers. The group met weekly to design and develop a web-based tool for sending and receiving secure messages. The group determined that the tool would need to be able to send and receive the message to a group or individual; the recipient should be able to claim responsibility and assure the issue is addressed; multiple care providers could append an open message; and when the issue is fully resolved the message identified as completed. All messages are patient centered and all previous messages are accessible by looking up the patient.

The new system provides reports that measure response time, time to completion, workload, quality monitoring, and the ability to analyze type of call and identify a better route for non-nursing patient concerns.

The patient centered, secure, web-based documentation system for telephone encounters has met patient and nursing expectations by providing better continuity of patient care, improved staffing for call volume, better turn around time with timely nurse/physician interaction, and improved skills on the computer for nurses.