Contents

Triage

This is an alternate version of our Triage policy for urgent care clinics. Practices who don't offer appointments will receive a different version of this page.

Policy

All practice staff are trained to recognise patients with urgent health needs, and to respond appropriately for their role.

Non-clinical staff induction includes training in phone triage, monitoring patients in the waiting area, and being able to alert clinical staff immediately if they are concerned about a patient. Team members are trained in CPR as appropriate to their role and practice needs.

Signage in the clinic provides information which:

• directs patients to reception on arrival
• describes how the triage system prioritises urgent needs
• lists life-threatening symptoms
• tells patients to alert clinic staff if they have a life-threatening medical need.

When allocating a triage category consider the risk of complex health conditions, and lack of access to services that disproportionately affect some groups, such as Māori.

See also Foundation Training – Urgent Health Needs

Patients arriving at the clinic

Patients may arrive at the clinic with emergency symptoms, and/or without an appointment. Appointments are usually carried out in the order they are booked in.

Patients without an appointment are triaged on arrival to determine their priority of treatment, and seen according to their clinical need. Our urgent care triage system is based on the Australasian College of Emergency Medical Triage Scale.

1. A triage nurse assesses patients and allocates a triage category within 10 minutes of arriving.
2. The triage nurse takes the patient to a private area, e.g. the triage room, and:
   • explains the reason for triage
   • takes a brief history of the patient's complaint and/or symptoms
   • takes vital observations
   • enters all observations in the patient's record.
3. The triage nurse allocates a triage category to the patient, gives an estimated wait time, and explains that this is subject to change.

If the patient has been categorised as Level 2, or if the triage nurse is concerned about a Level 3 patient, they ask a doctor to see the patient immediately.

The triage nurse and urgent care doctor communicate regularly regarding wait times and priorities. If the triage nurse cannot keep up with demand, they alert the nurse team leader and a second nurse is designated.

Encourage lower-priority patients, e.g. those categorised as Level 5, to make an appointment with their usual doctor the following day.

Monitoring waiting patients and wait times

Only clinical staff may diagnose a condition or provide medical advice. Avoid contact with a patient's blood or bodily fluids.

During the clinic's opening hours, a designated staff member monitors waiting areas regularly. They inform patients of wait times as needed. Wait times may also be available through signage. .

Non-clinical staff alert a nurse if:

• they are concerned about changes to a patient's condition
• wait times become longer than patient expectation.

Doctors see patients according to the triage category, not the estimated wait times. However, this is at the doctor's discretion and there may be exceptions.

Urgent phone calls and phone triage

If a patient phones with an urgent medical need:

• advise the patient to call 111 for an ambulance, or
• call and ambulance on their behalf.

When the patient's condition is not life-threatening, ask the patient to come into the clinic to be triaged.

Staffing levels, breaks, and handovers

Team members hand over to another person and advise reception when going on a break or at the end of a shift.

If patient flow exceeds capcity, the triage team may put the "at capacity" sign out.

See also Workload and Staffing

Transferring patients to secondary/tertiary care

If a patient requires transfer to another facility:

• The triage doctor must see the patient before they leave.
• The nursing team observe and monitor the patient until they leave.
• Document all care given, monitoring and observations, in the clinical notes.
• Formally hand over medical documentation to those transporting the patient.

See also Triage Audits

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Related Information Triage Audits