November 10, 2017

Nurse-run telephone triage service for after-hour calls by neurosurgery patients

By: Judy Mathias

Editor’s Note

Clinical Advice Service (CAS), a nurse-run telephone triage service for after-hour calls, developed at the Stanford University School of Medicine, provides well-coordinated care to neurosurgery patients while reducing physician workload, this study finds.

Between July 2016 and June 2017, CAS nurses received 1,021 after-hours calls from neurosurgery patients. More than 71% of the calls were clinical, and the rest were nonclinical (ie, directions, appointments, general information).

The nurses sent 37.3% of the clinical calls to the on-call neurosurgery physician, and 4.8% of patients were triaged to the emergency room.


It  is challenging for patients to reach their clinicians after-hours in a timely manner. This may result in worse health outcomes for the patients, or inappropriate utilization of emergency rooms and urgent care facilities. Physicians continue to remain overwhelmed with frequent after-hours calls in addition to other clinical responsibilities while on-call.


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