The safety of using active triage to provide advice rather than a face-to-face neurology outpatient appointment

J R Coll Physicians Edinb. 2019 Sep;49(3):193-198. doi: 10.4997/JRCPE.2019.305.

Abstract

Background: Neurology referrals from primary care are increasing. Actively triaging referrals is one way of providing a better patient-focussed service.

Methods: We reviewed the safety and cost-effectiveness of 'advice only' rather than face-to-face appointments for neurology patients via active triage. Referrals triaged as 'advice only' were identified over a 6-month period. Data were collected on reason for referral, opinion of triaging neurologist and whether the patient re-presented to neurology within 12 months.

Results: A total of 10% (236 out of 2,445) of referred patients were given advice only after active triage. A total of 71% (n = 167) had no further secondary care presentations in 12 months. The most common presentation was headache (n = 57; 13%). One patient had a major diagnostic change following delayed review.

Conclusions: 'Advice only' allows patients to receive timely advice and management. It appears safe and is likely to be cost effective, although further data are required on whether it provides satisfactory outcomes for patients and general practitioners.

Keywords: active triage; misdiagnosis; neurology; outpatients; safety.

MeSH terms

  • Ambulatory Care / economics
  • Diagnostic Errors / statistics & numerical data
  • General Practitioners*
  • Humans
  • Interprofessional Relations*
  • Neurologists*
  • Primary Health Care
  • Referral and Consultation* / economics
  • Triage / economics
  • Triage / methods*
  • United Kingdom