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RN Triage at the Right Time, Right Place, and for the Right Reason

RN Triage at the Right Time, Right Place, and for the Right Reason
author apree health

Authored by Michelle Lewis RN, Nurse Care Guide, apree RN Triage Nurse, and Certified Health Coach

Nurse telephone triage, an expanded healthcare service offered to apree care center members and now optionally available to apree digital and care guide clients, is impacting people’s lives in a big way.  Launched in 2023 to all of apree health’s Vera Care Centers, and 2024 to Castlight clients, RN triage provides real-time clinical phone support to patients with urgent symptoms.  The nurse triage team is helping to drive the company’s mission to reimagine how we deliver and pay for healthcare in the US.  Though sometimes patient symptoms warrant a quick trip to the emergency room, the triage nurses are proving they can reduce inappropriate high-cost ER visits.  In fact, in Q1 2024, 63% of patients received same-day or next-day appointments with a Vera Primary Care Provider, 27% of patients were directed to urgent care, and only 8% went to the ER. 

Since apree health goes beyond traditional healthcare delivery with its tech-enabled navigation platform and primary care model delivering value-based care, it is no surprise that RN triage services were at the forefront of the company’s extended access to care for patients.  The Centralized Clinical Programs team has streamlined the process of routing calls appropriately to the triage nurses, thus reducing provider interruptions during the clinical day, and unnecessarily directing patients to the emergency room. Not only do the triage nurses provide urgent assessment and guidance for people in need, but they also put their RN licenses to full use. They leverage their comprehensive care navigation skills to provide ongoing clinical support post-triage including follow-up calls 48 hours post-triage, medication management, patient education, and coordination of care with other healthcare professionals. These nurses ensure that patients receive continuous and holistic care, addressing not only immediate concerns but also facilitating follow-up and next steps. Their expertise extends to monitoring patient progress, adjusting care plans as needed, and advocating for patients within the healthcare system, thereby enhancing overall patient outcomes.

One such case of the importance of ongoing clinical support and integration with the care center teams is highlighted by a Western Washington Care Center patient named *Chris. In December 2023, Chris fainted at work prompting him to call his Vera provider for guidance.  He was connected with the RN Triage line and the nurse directed him to seek immediate medical care and provided local in-network options.  Chris was hospitalized for four days and treated for orthostatic hypotension, hyperglycemia, and cardiomyopathy.  Ongoing follow-up conducted by the triage nurse was critical in addressing Chris’s ongoing healthcare needs.  During a post-hospital discharge call, Chris informed the nurse that he had fainted again.  Sent home from the hospital with a list of new medications and between doctor’s visits, Chris was unsure who he should reach out to for guidance.  The nurse quickly gathered the details, educated Chris on safety precautions, and coordinated with the care center provider to schedule a next-day telemedicine visit, during which the provider collaborated with his cardiologist to ensure seamless care coordination.  The triage nurse continued to provide ongoing phone support for the patient to ensure his healthcare needs were met.  This combined with the prompt action taken by the provider and care center, Chris had a successful outcome and continued to improve.

“The nurse quickly gathered the details, educated Chris on safety precautions, and coordinated with the care center provider to schedule a next-day telemedicine visit…”

Not only are the triage nurses passionate about working with patients to find the optimal level of care, but they are also dedicated to providing high-quality, wrap-around services for ongoing care.  Having the unique opportunity to work with both digital solutions clients and advanced primary care patients allows the nursing team to address care needs through a broader scope while still driving home the most important aspects, such as ensuring clients have a high-quality in-network primary care provider and are up to date on all preventative exams and disease-specific screenings. By ensuring care is delivered at the Right Time, in the Right Place, and for the Right Reasons, they significantly enhance patient outcomes, promote continuity of care, and support holistic health and well-being.

*Name changed for privacy

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