ArticleBMC family practice2020
Safety, efficiency and health-related quality of telephone triage conducted by general practitioners, nurses, or physicians in out-of-hours primary care: a quasi-experimental study using the Assessment of Quality in Telephone Triage (AQTT) to assess audio-recorded telephone calls.
Article in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- The Role of Language in Remote Healthcare Triage: A Meta-Aggregative Review.Journal of advanced nursing · 2025Pooled it
- Task shifting from general practitioners to other health professionals in out-of-hours primary care - a systematic literature review on content and quality of task shifting.The European journal of general practice · 2024Pooled it
- Telehealth and access to acute primary care in Europe: Balancing opportunity and equity.The European journal of general practice · 2026Article
- Task shifting from general practitioners to nurses and the association with patient flow and resource use in out-of-hours primary care clinics: a descriptive register-based study.Scandinavian journal of primary health care · 2026Article
- Telephone triage in urgent unscheduled primary care in 16 European countries: a cross-national questionnaire-based expert study.Scandinavian journal of primary health care · 2026Article
- Patient-Facing AI System for Symptom Guidance Using Simulated Encounters and Physician Review: Analytical Validation Study.JMIR formative research · 2026Article
- Increased Utilization of Telemedical Emergency and Nonurgent Care Following Deployment of Virtual Triage and Care Referral in Australia.Mayo Clinic proceedings. Digital health · 2026Article
- Observational
- Nurse triage in primary care: concept analysis.BMC nursing · 2025Article
- Impact of video service failure on triage outcomes in Danish out-of-hours primary care: a register-based study across four regions.BMJ open · 2025Observational
- Task shifting from general practitioners to nurses in out-of-hours primary care: an explorative case study of team-based practices.Scandinavian journal of primary health care · 2025Article
- Adverse working conditions in Romanian out-of-hours primary care (OOH-PC): an interview study.Human resources for health · 2025Article
- Safety and accuracy of digitally supported primary and secondary urgent care telephone triage in England: an observational study using routine data.BMC medical informatics and decision making · 2025Observational
- How Healthcare Providers Decide on a Referral Location in Telephone Triage: A Cross-sectional Study.Journal of general internal medicine · 2024Article
- Building a performance measurement framework for telephone triage services in Finland: a consensus-making study based on nominal group technique.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Descriptive analysis and evaluation of Health Link referrals to the emergency department before and during the COVID-19 pandemic.Internal and emergency medicine · 2024Article
- Identifying performance indicators to measure overall performance of telephone triage - a scoping review.Scandinavian journal of primary health care · 2024Article
- What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study.BMC health services research · 2023Article
- Development over time in point-of-care test use in Danish daytime and out-of-hours general practice: a register-based study.Scandinavian journal of primary health care · 2023Article
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTo explore and compare safety, efficiency, and health-related quality of telephone triage in out-of-hours primary care (OOH-PC) services performed by general practitioners (GPs), nurses using a computerised decision support system (CDSS), or physicians with different medical specialities.
methodsNatural quasi-experimental cross-sectional study conducted in November and December 2016. We randomly selected 1294 audio-recorded telephone triage calls from two Danish OOH-PC services triaged by GPs (n = 423), nurses using CDSS (n = 430), or physicians with different medical specialities (n = 441). An assessment panel of 24 physicians used a validated assessment tool (Assessment of Quality in Telephone Triage - AQTT) to assess all telephone triage calls and measured health-related quality, safety, and efficiency of triage.
resultsThe relative risk (RR) of poor quality was significantly lower for nurses compared to GPs in four out of ten items regarding identifying and uncovering of problems. For most items, the quality tended to be lowest for physicians with different medical specialities. Compared to calls triaged by GPs (reference), the risk of clinically relevant undertriage was significantly lower for nurses, while physicians with different medical specialties had a similar risk (GP: 7.3%, nurse: 3.7%, physician: 6.1%). The risk of clinically relevant overtriage was significantly higher for nurses (9.1%) and physicians with different medical specialities (8.2%) compared to GPs (4.3%). GPs had significantly shorter calls (mean: 2 min 57 s, SD: 105 s) than nurses (mean: 4 min 44 s, SD: 168 s).
conclusionsOur explorative study indicated that nurses using CDSS performed better than GPs in telephone triage on a large number of health-related items, had a lower level of clinically relevant undertriage, but were perceived less efficient. Calls triaged by physicians with different medical specialities were perceived less safe and less efficient compared to GPs. Differences in the organisation of telephone triage may influence the distribution of workload in primary and secondary OOH services. Future research could compare the long-term outcomes following a telephone call to OOH-PC related to safety and efficiency.
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