Capturing clinical triage encounters

Clinical triage encounters with patients should be captured in the appointment ledger. These may or may not involve real-time interaction with the patient or their representative. Examples of single clinical triage encounters are:

• a clinician reviews an online consultation then telephones the patient to complete the triage and determines that a face-to-face appointment is required
• a clinician reviews an online consultation, prescribes suitable medication, and sends a text message to advise the patient to collect this from their nominated pharmacy
• a receptionist places a patient on a call-list for clinical triage and the clinician contacts them by video to carry this out

Any clinical triage encounter is an appointment/contact that requires a 'Bookable Slot Type'.

Practices employ many different approaches to managing clinical triage within and without their main clinical system. As well as SystmOne, tools such as the appointment ledger and tasks, external systems and tools are likely to be involved such as online consultation software, website forms, spreadsheets, and hard copy.

Therefore, prescriptive action is not requested, rather practices are asked to review how clinical triage encounters are recorded in their Appointment Ledger and any other systems and to consider and implement how clinical triage encounters can be most efficiently and effectively captured in the appointment ledger without introducing undue burden.

Suggested actions are:

1. Review your slot types for clinical triage encounters against working practice and ensure that slot types are in place which:

• each map to the national category of triage
• have an appointment flag which reflects the mode of the encounter
• have names which reflect the category and mode as well as being meaningful to local users, for example clinical triage/video’, OC clinical triage review/telephone
• make use of colour coding and flags to promote appropriate use of slot types

2. Rotas can be used to create appointment book ‘work-off’ lists of patients awaiting clinical triage.

3. When booking patients in, use a slot type with an appointment flag that is most likely to be appropriate for these encounters, for example if most of your clinical triage encounters are over the telephone, use a slot type with the appointment flag telephone appointment.

4. If tools other than the appointment ledger are used to create a work-off’ list of patients awaiting clinical triage, these encounters could be entered as appointments as they are completed by the clinician.

5. Ensure that any clinical triage completed by the duty doctor or other duty HCP is accurately recorded.