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Telephone Triage

Oct. 17, 2019 – My latest travels took me to Copley for a visit with the telephone triage team. Manager Donna Donoghue leads this hardworking group of nurses and their admin extraordinaire, Lauren Berra, in fielding after-hours parent and caregiver calls for various health care entities, both within the Rady Children’s family and beyond. Telephone triage professionals help callers with everything from determining the best course of care for a child with a cold to talking through a child’s serious injury and guiding them to the optimal emergency medicine location — they really hear it all! Through my years as a physician, I was familiar with the concept of telephone triage, but arrived eager to learn how our specific team operates.

Donna met me in the Copley lobby and led me back to a conference room, where I first had the opportunity to have a roundtable meet-and-greet with team members over a Mediterranean feast. A big point of emphasis was how diverse the team’s professional background is, and understandably so — it was quite interesting. For example, Raul Pitre-Lopez originally came to San Diego when he was stationed here as an aviation electrician with the United States Navy, but stayed to pursue his passion for nursing. Jen Peterson worked at Rady Children’s back in 1998 until she moved to Germany with her family. After returning to the U.S., she got a job as a school nurse, but found her way back to our Hospital and has been with us again for more than four years. And Kathleen Greenway always had a career in health care — starting in quality and operations — but found her true calling in nursing. Team members also have “past nursing lives” in areas including adult medicine, community medicine, hematology/oncology and intensive care, which funnels an array of unique perspectives and experiences toward one common goal: helping families find a sense of calm and relief and getting them connected with the care their child needs. As Deborah Fagerwick put it, “What we do is a very simple thing … but it’s what these families really need.” Considering telephone triage often manages high-stress and complex cases without ever seeing a patient in person, referring to their challenging roles as simple — and in such a humble way — is a mark of real expertise!

Show time!

After we finished snacking, it was movie time! Raul and Gail Garcellano put together a short video that walked me through a telephone triage call, with Raul playing a parent concerned about his young daughter’s sore throat. Gail was very thorough, asking about key information such as the little girl’s behavior, medications, status of normal functions and past health events of note. She helped “dad” map out an at-home treatment plan, and patiently explained why going to an emergency room wouldn’t be necessary. Although this was a mock scenario, I’m confident Gail and all of the triage nurses apply this same measured and compassionate approach to all of their calls, and I loved getting a glimpse at their process.

Next, we walked through a presentation highlighting a bit more about telephone triage’s day-to-day. As mentioned above, they handle after-hours (although not 24/7) calls from parents and caregivers whose children are seen at a number of health care entities. Through monthly contracts, the team works with Children’s Primary Care Medical Group; Children’s Medical Group; ENT, orthopedic, urology, ophthalmology and rehabilitation medicine specialty clinics at Rady Children’s; pediatric offices at Scripps and Sharp Grossmont; California Kids Care; and some individual providers. They also offer what I’d call a “triage lite” service to 360 Sports Medicine and CHOC patients, as well as some Qualcomm employees, in which they can assist in finding case-appropriate care near callers and provide guidance on follow-up care. It’s no wonder they stay so busy! In fact, I learned that between FY18 and 19, the team took 23,988 calls, with about 18,000 coming from CPCMG families. I also found out that they take a number of calls from abroad, with families on vacation calling in with questions, concerns or requests for help. Last but not least, we discussed the team’s strong engagement scores, which resulted in some kind words for Donna, and high patient satisfaction scores.

Officially stamped

At that point, it was time for me to be on my way — but not before I got my passport stamped! Raul and Donna shared the stamping honors, and shout-out to Belinda Catalma for the fantastic design. Thank you for a welcoming and interesting visit, and for all you do to help our community’s families — even if they’re halfway around the world!