Objective:

Build a curriculum to support and improve neurology resident’s telephone triage skills of a patient emergency response line.  

Background:

Many neurology trainees answer patient questions over the telephone while on call with minimal training or experience. Other non-neurology residencies have published quality improvement studies on trainee specific training on telephone triage skills. Not all institutions have imbedded training for residents on telephone triage skills. 

Design/Methods:

Two months of pages routed through the pager response line were collected at an academic institution. A list of neurological complaints was created based upon the text of the page. Residents completed a pre-intervention survey of confidence level for management telephone triage. Based upon aggregated data of common neurologic complaints, a 1-hour lecture was given and triage flowsheets were developed to train residents on appropriate over-the-phone management of common neurological complaints. A post-intervention self-evaluation survey is planned for one month after the flowsheets are distributed to the residents. 

Results:

The most common neurological complaints from patients using the pager response line were breakthrough seizure, persistent or worsening headache, a new neurological symptom, or worsening functional decline (46% of pages). Other common indications for calls included concern for a medication side effect or request for medication refills (35% of pages). For the pre-intervention survey, the majority of the residents (80%) responded as “not at all confident” to “somewhat confident” in their response to “How confident are you with answering pager response line pages independently?”. 

Conclusions: