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September 8, 2020

911 vs. Veterinary Teletriage

As you look into providing teletriage for your veterinary clients, be aware that some clients will assume you are now offering a 911-style service for their pets...
Holly Sawyer, DVM, Human-Animal Bond Certified, Regional Veterinary Consultant

As you look into providing teletriage for your veterinary clients, be aware that some clients will assume you are now offering a 911-style service for their pets. To ensure your clients perceive the greatest value in this new service, it is important to clarify for them what GuardianVets service is—and what it isn’t.

GuardianVets teletriage IS a service in which:

  • Credentialed veterinary professionals answer calls.
  • Emergent versus non-emergent issues are sorted.
  • Non-emergent concerns are funneled back to the practice.
  • Emergent concerns are directed as the practice dictates.

GuardianVets teletriage DOES NOT provide:

  • A diagnosis, treatment, or medication recommendations.
  • Immediate, travel-to-your-home resources for life-threatening conditions (i.e., no 911 for pet owners).
  • Nor should your clients expect to have their calls answered on the second ring.

While our triagers have been known to talk pet owners through administering CPR like 911 dispatchers, the fact remains that 911 is a very specialized subset of teletriage. A little history will give you the perspective you need to frame your new teletriage service appropriately.

Napoleon’s Genius

The concept of triage was first codified in 1792 by Napoleon’s Surgeon in Chief, Dominique Jean Larrey, who vastly improved patient outcomes in the Napoleonic Wars by directing soldiers to surgery based on severity of injury rather than nationality or rank. In fact, the very term triage has its roots in the French word trier, which means "to sort or separate."

Indeed, the major tenets of triage have not changed in the last 228 years. All you need is multiple patients, different degrees of illness or injury, and at least one limited resource. At its very essence, triage then becomes a question of separating patients who will be fine no matter what intervention they receive, patients who will die no matter what intervention they receive, and patients who will fundamentally benefit from intervention.

Today’s Challenges

While triage algorithms have become more elegant with the advent of modern diagnostics, today’s medical personnel can still feel like they are on a battlefield due to intense public demand for immediate help. This was a reality back in 1967, when President Lyndon B. Johnson called for a national emergency phone number (911) to facilitate public access to police, fire, and medical services. It is even more of a reality today.

Plus, the 911 triage process can be complex. 911 operators serve as the point of first contact for frightened members of the public. Based on intake information and pointed questions, the 911 dispatcher then triages callers to first responders, who triage them to proper emergency care facilities, who triage them as newly admitted patients to appropriate treatments. At each point, the condition of the patient may change, potentially altering the previous triage category.

In addition, the National Emergency Number Association (NEMA) reports that 268,000 calls are placed to 911 daily. With such horrendous call volume, many regions have turned to automated dispatch software to help operators transfer calls to the appropriate authorities. But in complex incidents, more than one first responder category may be sent to the scene. With so many players, the process must be technologically integrated while remaining agile.

True, this chain of events starts with a telephone call, just like your clinic’s after-hours teletriage service. But 911’s public service mandate, call volume, and multi-layered chains of action clearly turn it into a different animal entirely within the teletriage landscape.

Advice Nurses

Human medical teletriage services, manned by RNs, have brought new depth to the teletriage landscape over the last decade. Instead of being modeled on Multiple Casualty Incident (MCI) triage or acute crisis intervention, advice nurse services focus on individual patient care for minor ailments and chronic illness.

Registered Nurses follow standardized, evidence-based triage algorithms to categorize callers appropriately and counsel patients on the appropriate use of OTC medications and home interventions when indicated. Patients call a nurse triage hotline instead of 911 because they believe they are stable. It bears noting, however, that one human teletriage provider found that 8% of RN teletriage calls resulted in recommendations for urgent care, Emergency Room care, or even calling 911 for the fastest intervention possible.

It is veterinary teletriage’s turn to stretch its wings and provide the furry and feathered members of the family the same level of expert care.

Below is a table summarizing the similarities and differences between 911 dispatch, RN teletriage, and veterinary (specifically GuardianVets) teletriage services.

Comparison Chart of 911, Advice Nurse, and Veterinary Teletriage:

I hope this chart helps you understand the value that GuardianVets teletriage service can bring to your practice and your clients. A day may come when a state-funded, central dispatch service directs veterinary ambulances to a pet’s door. But until that day, the accurate triage recommendations provided by GuardianVets’s triagers will ensure your patients receive the best care and your clients experience continued success as they seek to love their pets well.

***

The following resources were used to research this article:

https://psc.apcointl.org/2013/06/28/simplified-call-center-staffing/

https://lris.com/2019/07/09/answering-calls-for-16-hours-staffing-issues-mandatory-overtime-stresses-countys-911-dispatch-center/

https://www.911.gov/pdf/Minimum_Training_Guidelines_for_911_Telecommunicator_2016.pdf

https://www.cityofberkeley.info/uploadedFiles/Auditor/Level_3_-_General/Dispatch%20Workload_Fiscal%20Year%202018.pdf

https://www.govtech.com/em/emergency-blogs/disaster-zone/whopaysfor911service.html

https://www.datatech911.com/resources/triage-status/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564046/

https://en.wikipedia.org/wiki/Triage

https://en.wikipedia.org/wiki/Dominique_Jean_Larrey

https://www.countyofunion.org/site/cpage.asp?cpage_id=180009766&sec_id=180003667

https://www.ktvu.com/news/abuse-of-911-alarming-number-of-callers-use-emergency-service-as-customer-service-line

https://www.ncjrs.gov/pdffiles/911.pdf

https://triagelogic.com/quantifying-how-nurse-triage-decreases-morbidity-and-mortality/

https://study.com/articles/911_Operator_Career_Information_and_Requirements.html

https://www.registerednursing.org/specialty/telephone-triage-nurse/

https://www.simplyhired.com/search?q=tele+triage+rn&job=kVS7OnKCq_cFXeLpMn4S_wFM2-fhouLN5lowaRLI30Yi7ogbL5-WyA


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