Clinical Decision Making and Your Unlicensed Staff

We all agree that clinical decision making is not within scope for the non-clinical staff in your call center or clinic (the agents, the patient service representatives, the schedulers…). It’s not safe for the patients and it’s not legal. So why do so many organizations allow or even force these staff members to make clinical decisions?

Think about patients that call with one or more acute symptoms. They often are asking for an appointment, or maybe they’re wondering if they should schedule an appointment or talk to a medical professional.

In an ideal world, all of these callers would be transferred to a nurse or provider who would be quickly available to triage the patient. Maybe this describes your organization. If so, that’s wonderful – congratulations! But unfortunately for the majority of organizations, this is simply not possible. You likely don’t have enough nurses or doctors to answer these calls, especially during your busy times. And probably not quickly enough to identify the potential urgent and emergent calls scattered throughout the less acute calls.

So what do you do? Many organizations will create a list of symptoms and say “these are the symptoms that are truly emergent or urgent, transfer these to a nurse”. These lists are typically called red flag lists or critical symptom lists or sometimes symptom checkers (though the latter more commonly refers to a different type of patient-facing software). So do these lists get rid of the risk for clinical decision making by your unlicensed staff? Not entirely. Let’s look into why.

Perhaps your list has “abdominal pain” on it. What if the caller says they have “stomach pain” or “my belly really started hurting after dinner last night” or “my son got tackled playing high school football and he really hurts, especially around his rib cage on the right side”. Are those cases of abdominal pain that should be urgently transferred to the nurse? Or are they something else related to a different symptom on the list? Who’s making that clinical decision?

SymptomScreen can remove this clinical decision making from your staff and at the same time result in more appropriate prioritization of your patients. It helps identify the appropriate symptoms – it knows that belly pain and stomach pain are the same as abdominal pain, and it can suggest rib injury questions for the football injury. It then provides a few precise yes or no questions for your staff to ask in order to gather additional data. Then based entirely on the caller’s answers and not on your unlicensed staff’s clinical decision making, a priority is assigned and subsequent steps are provided.

We all agree that clinical decision making is not in scope for your non-clinical contact center staff. So are you ready to ditch the red flag list and give SymptomScreen a try? Schedule a demo today or start a free trial to learn more!

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