What is Total Triage?

  • Total triage means that every patient contacting the practice is first triaged before making an appointment.
  • The purpose of total triage is to get patient need met by the most appropriate person or service with the minimum amount of handoff.
  • The total triage model aims to help practices better meet patient demand within their existing capacity by using the skill-mix of the wider team, utilising online services, telephone and video consultations as well as face-to-face consultations when needed.
  • It explicitly acknowledges that a large proportion of the need that presents to general practice does not need a general practitioner to deal with it, and in fact is likely to be better managed by another person, service or by the patient themselves if they have access to the right information.
  • The three critical steps in a triage model of general practice are: asking patients what they need, signposting by administrative teams and clinical triage.
  • There are two main routes into triage systems:
    • Online consultations/eConsult
    • Telephone
  • It offers a way of managing patient demand and improving efficiency.
  • It mainly focuses on reactive care to expressed patient need, rather than proactive care such as immunisation or antenatal care.

Benefits

To patients

  • Higher user satisfaction – patients access a clinician in real time, and more appropriately
  • Elimination of travelling, saving travel costs and reducing the carbon footprint
  • Elimination of waiting room time
  • Reduced need for face to face consultations
  • Less of an ‘appointment lottery’
  • By asking the patients about their reason for contacting the practice, patients are more likely to get their need met by the right person, service or information
  • Triage offers the opportunity for continuity with a specific clinician if it is needed

To the practice

  • Improved ability to offer contacts (increased throughput)
  • Reduction in clinical variation (quantitative and qualitative)
  • Increased throughput (better access, at comparatively lower cost)
  • Improved use of skill mix (including highly trained admin staff)
  • Reduction in DNAs to 2% or less
  • Reduced acute spend
  • Flexible use of capacity, moving away from the ‘10-minute model’ of care
  • ‘Getting today’s work done today’, and the work of the consultation done in real-time
  • Increased possiblity of giving continuity to patients that need it
  • Decreased sense of professional isolation by working in shared rooms
  • Remote working for team members enabled
  • Allows team members to develop their skills and give real career progression as they work at the ‘top of their licence’.
  • Upskill staff especially when admin feel less confident about different task
  • Gives opportununities for real team working around the needs of patients
  • Helps solidify relationships within the team
  • Utilises resources effectively
  • Helps embed a positive culture
STAGE 1

Deciding to proceed

STAGE 2

Project Set Up

STAGE 3

Technical Set Up

STAGE 4

Practice Set Up

STAGE 5

Triage team Set up

STAGE 6

Go Live

STAGE 7

Monitor and respond