ArticleQuality & safety in health care2007
Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?
Article in Quality & safety in health care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- The Role of Language in Remote Healthcare Triage: A Meta-Aggregative Review.Journal of advanced nursing · 2025Pooled it
- Factors affecting communication during telephone triage in medical call centres: a mixed methods systematic review.Systematic reviews · 2024Pooled it
- Safety of telephone triage in out-of-hours care: a systematic review.Scandinavian journal of primary health care · 2011Pooled it
- A Symptom-Checker for Adult Patients Visiting an Interdisciplinary Emergency Care Center and the Safety of Patient Self-Triage: Real-Life Prospective Evaluation.Journal of medical Internet research · 2024Trial
- The Role of a Decision Support System in Back Pain Diagnoses: A Pilot Study.BioMed research international · 2019Trial
- The effect of nurses' preparedness and nurse practitioner status on triage call management in primary care: A secondary analysis of cross-sectional data from the ESTEEM trial.International journal of nursing studies · 2016Trial
- Impact of a telenursing service on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized trial study protocol.BMC pediatrics · 2014Trial
- Trial
- Evaluation of the performance of telephone triage service.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Scoping review of nurse triage in primary care.BMC nursing · 2025Article
- Impact of COVID-19 pandemic on the accuracy of telephone triage of callers with shortness of breath and/or chest discomfort in Dutch out-of-hours primary care: A retrospective observational study.The European journal of general practice · 2024Observational
- Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis.BMJ quality & safety · 2024Article
- Safety in Teletriage by Nurses and Physicians in the United States and Israel: Narrative Review and Qualitative Study.JMIR human factors · 2024Review
- "ChatGPT, Can You Help Me Save My Child's Life?" - Diagnostic Accuracy and Supportive Capabilities to Lay Rescuers by ChatGPT in Prehospital Basic Life Support and Paediatric Advanced Life Support Cases - An In-silico Analysis.Journal of medical systems · 2023Article
- Evaluation of telephone triage among chest pain patients in out-of-hours primary care in the Netherlands (TRACE).Family practice · 2023Observational
- Safety of Triage Self-assessment Using a Symptom Assessment App for Walk-in Patients in the Emergency Care Setting: Observational Prospective Cross-sectional Study.JMIR mHealth and uHealth · 2022Observational
- Quality indicators in telephone nursing - An integrative review.Nursing open · 2021Review
- The implementation of the nationwide out-of-hours phone number 1733 in Belgium: analysis of efficiency and safety.Primary health care research & development · 2021Article
- Human- Versus Machine Learning-Based Triage Using Digitalized Patient Histories in Primary Care: Comparative Study.JMIR medical informatics · 2020Article
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn recent years, there has been a growth in the use of triage nurses to decrease general practitioner (GP) workloads and increase the efficiency of telephone triage. The actual safety of decisions made by triage nurses has not yet been assessed.
objectivesTo investigate whether triage nurses accurately estimate the urgency level of health complaints when using the national telephone guidelines, and to examine the relationship between the performance of triage nurses and their education and training.
methodA cross-sectional, multicentre, observational study employing five mystery (simulated) patients who telephoned triage nurses in four GP cooperatives. The mystery patients played standardised roles. Each role had one of four urgency levels as determined by experts. The triage nurses called were asked to estimate the level of urgency after the contact. This level of urgency was compared with a gold standard.
resultsTriage nurses estimated the level of urgency of 69% of the 352 contacts correctly and underestimated the level of urgency of 19% of the contacts. The sensitivity and specificity of the urgency estimates provided by the triage nurses were found to be 0.76 and 0.95, respectively. The positive and negative predictive values of the urgency estimates were 0.83 and 0.93, respectively. A significant correlation was found between correct estimation of urgency and specific training on the use of the guidelines. The educational background (primary or secondary care) of the nurses had no significant relationship with the rate of underestimation.
conclusionTelephone triage by triage nurses is efficient but possibly not safe, with potentially severe consequences for the patient. An educational programme for triage nurses is recommended. Also, a direct second safety check of all cases by a specially trained GP telephone doctor is advisable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.