RN Telehealth Triage and Disposition Services

Pre-Service Preparation

Patient Verification

Verify patient identity using two identifiers: full name and date of birth. For third-party callers, obtain caller's name, relationship to patient, and verify authorization. Document patient and caller locations for regulatory compliance and emergency protocols.

Technology Setup

Establish secure, HIPAA-compliant telehealth platform with high-quality audio capabilities. Ensure access to evidence-based triage protocols and verify backup communication methods and emergency contact procedures.

Clinical Preparation

Review electronic health records when available, focusing on relevant medical history. Assess patient's chronic conditions, current medications, and recent healthcare encounters. Prepare systematic assessment tools for high-risk conditions.

Consent and Authorization

Explicit Consent Requirements

Obtain explicit consent for telehealth triage services and potential call recording. Explain the nature of telehealth services, limitations of remote assessment, and patient rights during the consultation process.

• Document verbal consent in patient record
• Explain service limitations and scope
• Clarify emergency procedures
• Provide opt-out options

Third-Party Authorization

When family members or caregivers call on behalf of patients, establish clear authorization protocols to protect patient privacy while ensuring appropriate care coordination.

Professional Call Initiation

Standard Professional Introduction

Begin each call with a warm, professional greeting that establishes your credentials and role. A typical introduction should include: "Good [morning/afternoon], this is [Name], I am a registered nurse with [Organization]. Thank you for calling our triage service today."

Apologize for any delays and thank the caller for using the triage service. Explain your role and the session structure clearly: "I will ask you some questions to help determine the best care for [patient name]."

Key Communication Elements

• Professional identification
• Warm, caring tone
• Clear explanation of process
• Active listening techniques
• Empathetic responses

SAVED Protocol: Emergency Assessment

Disposition Categories

Clinical Decision-Making

Integration of Clinical Assessment

Apply critical thinking skills to integrate protocol recommendations with comprehensive clinical assessment findings. Evidence-based protocols provide the framework, but professional nursing judgment remains essential for individualizing care recommendations.

Consider upgrading disposition when clinical judgment indicates higher risk than protocol recommendations suggest. Factors such as patient anxiety, social isolation, or inability to return for follow-up may warrant more conservative disposition decisions.

Collaboration and Consultation

• Document consultation requests
• Present cases systematically
• Follow physician recommendations
• Maintain clear communication

Documentation Requirements

Patient Demographics and Call Details

Record complete patient demographic information including full name, date of birth, contact information, and caller relationship if different from patient. Document call start and end times, and method of communication used.

Chief Complaint Documentation

Document chief complaint using caller's exact words when possible, followed by systematic assessment findings. Include all positive and negative responses to triage assessment questions as required by protocol.

Clinical Decision-Making

Record protocol used, disposition recommended, and clinical rationale for decisions made. Document any deviations from protocol recommendations with clear justification based on clinical assessment findings.

Instructions and Follow-Up

Document all instructions provided to patient, patient's stated understanding and agreement, and any follow-up plans established. Include emergency warning signs discussed and callback instructions given.

Quality Assurance Metrics