ArticleBMC health services research2017
Development and testing of the KERNset: an instrument to assess the quality of telephone triage in out-of-hours primary care services.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors affecting communication during telephone triage in medical call centres: a mixed methods systematic review.Systematic reviews · 2024Pooled it
- Chest discomfort at night and risk of acute coronary syndrome: cross-sectional study of telephone conversations.Family practice · 2020Trial
- How Healthcare Providers Decide on a Referral Location in Telephone Triage: A Cross-sectional Study.Journal of general internal medicine · 2024Article
- Identifying performance indicators to measure overall performance of telephone triage - a scoping review.Scandinavian journal of primary health care · 2024Article
- The telephone nursing dialogue process: an integrative review.BMC nursing · 2023Article
- Factors associated with undertriage in patients classified by the need to visit a hospital by telephone triage: a retrospective cohort study.BMC emergency medicine · 2021Article
- Quality indicators in telephone nursing - An integrative review.Nursing open · 2021Review
- Co-location of out of hours primary care and emergency department in Belgium: patients' and physicians' view.BMC health services research · 2021Article
- Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France.BMC health services research · 2019Article
- Observational
- Quality of out-of-hours telephone triage by general practitioners and nurses: development and testing of the AQTT - an assessment tool measuring communication, patient safety and efficiency.Scandinavian journal of primary health care · 2019Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTelephone triage is a core but vulnerable part of the care process at out-of-hours general practitioner (GP) cooperatives. In the Netherlands, different instruments have been used for assessing the quality of telephone triage. These instruments focussed mainly on communicational aspects, and less on the medical quality of triage decisions. Our aim was to develop and test a minimum set of items to assess the quality of telephone triage.
methodsA national survey among all GP cooperatives in the Netherlands was performed to examine the most important aspects of telephone triage. Next, corresponding items from existing instruments were searched on these topics. Subsequently, an expert panel judged these items on importance, completeness and formulation. The concept KERNset consisted of 24 items about the telephone conversation: 13 medical, ten communicational and one regarding both types. It was pilot tested on measurement characteristics, reliability, validity and variation between triagists. In this pilot study, 114 anonymous calls from four GP cooperatives spread across the Netherlands were judged by three out of eight raters, both internal and external raters.
resultsCronbach's alpha was .94 for the medical items and .75 for the communicational items. Inter-rater reliability: complete agreement between the external raters was 45% and reasonable agreement 73% (difference of maximally one point on the five-point scale). Intra-rater reliability: complete agreement within raters was 55% and reasonable agreement 84%. There were hardly any differences between internal and external raters, but there were differences in strictness between individual raters. The construct validity was confirmed by the high correlation between the general impression of the call and the items of the KERNset. Of the differences within items 19% could be explained by differences between triage nurses, which means the KERNset is able to demonstrate differences between triage nurses.
conclusionsThe KERNset can be used to assess the quality of telephone triage. The validity is good and differences between calls and between triage nurses can be measured. A more intensive training for raters could improve the reliability.
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