Why Red Flag Lists and Critical Symptom Lists are Flawed

In healthcare contact centers, a primary goal is to provide prompt and accurate assistance to patients, ensuring they are transferred to or connected with the appropriate level of care. Traditionally, call center agents have relied on red flag lists and critical symptom lists as tools to identify urgent symptoms. However, as the healthcare landscape evolves, it’s essential to recognize that these lists have limitations and drawbacks.

1. Overemphasis on Specific Symptoms
   

   Red flag lists and critical symptom lists tend to focus on a limited set of symptoms or conditions deemed as high-risk. While this approach can be helpful for identifying emergencies, it may lead to overlooking other equally important health concerns. Not all urgent medical conditions present with the same red flag symptoms, and relying solely on these lists may delay necessary care for patients with less apparent but still critical health issues.

2. Generalization and Incomplete Lists
   

   These lists often generalize symptoms and do not allow the agent to ask the caller questions about additional symptoms they may be experiencing. In order to make a red flag list a usable tool for the agent, symptoms must be condensed into one or two pages, making it incomplete. As a result, agents using red flag lists might overlook many symptoms and fail to provide transfer to the appropriate level of care.

3. Failure to Update and Maintain Lists
   

   Healthcare is a rapidly evolving field, with new research and medical insights emerging frequently. It can be difficult for your medical leaders to find the time to update these lists. And because red flag lists and critical symptom lists are often found in training binders, printed and kept on desks, or linked to on a shared internal page, they can be very difficult to update. Relying on outdated information can lead to the agent taking the inappropriate step for the caller, compromising their well-being.

4. The Potential for Errors and Omissions
   

   In some cases, red flag lists and critical symptom lists may inadvertently exclude essential symptoms or conditions. Such omissions could lead to missed opportunities for early intervention or timely medical advice, affecting patient outcomes negatively.

5. Clinical Decision Making
   

   Clinical decision making is not within the scope of the non-clinical contact center agent. Unfortunately, listening to a caller and trying to decide whether what they are describing meets the criteria on the red flag list often involves clinical decision making. Think about it – would two different agents using a red flag list wind up at the exact same outcome for a complex call? Or a set of symptoms described by a confused caller? If not, is it because they’re making different clinical decisions?

6. Training of the Agent
   

   Red flag lists and critical symptom lists typically require training and explanation to use. Additionally, they often are unable to list directions and steps for the agent to take for each symptom which can leave the agent wondering and guessing about what they should do for the caller. All of this is complicated with a position that requires minimal education and has high turnover.

7. Incomplete or Insufficient Documentation
   

   Red flag and critical symptom lists do not generate documentation. It is up to the agent to document what happened on the call and why they took the steps they did. Sometimes this step can be overlooked leading to incomplete documentation, especially when call volumes are high and agents are busy.

A More Effective Approach

To improve patient care and call center efficiency, healthcare contact centers should consider adopting a more modern approach. SymptomScreen allows the agent to search for and select a symptom or symptoms based on what the caller is reporting and enables them to ask yes or no questions about that symptom. Based on the caller’s response to the questions, a priority is then assigned to the call and the agent is told what action to take next. Best of all, these actions and instructions are completely customizable to fit the workflow in any call center. And at the end of the call SymptomScreen will create a note that can then be used as documentation in the patient’s medical record or sent as a message to nurse triage.

Conclusion

While red flag lists and critical symptom lists have served as important tools for healthcare call center agents, they may no longer meet the demands of modern healthcare. Emphasizing a more complete and functional tool will empower call center agents to deliver better care to patients. By rethinking the reliance on outdated lists and embracing a more detailed approach, healthcare call centers can continue to evolve and use SymptomScreen to provide exemplary service in today’s dynamic healthcare landscape.