Introduction: The Memorial Sloan Kettering (MSK) Urgent Care Center (UCC) functions as the emergency room for MSK patients. With 23,000+ presentations annually, increasing volume and acuity mean more days over capacity. Patients experience increased wait times to see a provider, complete evaluation, and transfer to inpatient bed. The goal of UCC TeleTriage is to streamline patient flow through UCC and improve patient experience by aligning patient need and volume with resources.
Methods: UCC TeleTriage began July 2018 with the Gastrointestinal Medical Oncology service. The Service RN refers patients to TeleTriage weekdays, from 9a.m.- 4:30p.m. The TeleTriage provider calls patient within 30 minutes, takes history, and determines initial plan. Depending on acuity, evaluation starts prior to registration in UCC, using zip code and GPS to identify appropriate testing site. Patients who are too ill are directed straight to UCC.
Results: TeleTriage patients have (virtual) contact with a provider within 30 minutes and are discharged from UCC 42 minutes more rapidly than non-TeleTriage patients, who waited 110 minutes to see a provider. TeleTriage patients who received imaging prior to UCC, received a final disposition 93 minutes sooner than non-TeleTriage patients. A small number of low acuity patients were fully managed at home or in outpatient clinics.
Conclusion: Discharge of TeleTriage patients is measurably more rapid compared with non-TeleTriage patients. TeleTriage patients also had more rapid contact with a provider and earlier initiation of evaluation. Video-assisted TeleTriage is slowly being added. There is a new trend of managing less acute patients completely remotely.