Paper-based preconsult triage system
At Essentia Health, an integrated health care system with facilities in Minnesota, Wisconsin, and North Dakota, Meghan Scheibe, MD, a rheumatologist, is currently working with a rheumatologist colleague and a registered nurse to implement a paper-based preconsult triage system, “because our wait times have unfortunately skyrocketed,” she said. “We receive a lot of outside referrals from other health care groups and large health care systems that don’t have access to rheumatology.” Currently, the triage system is comprised of a referral note which includes the reason for consultation. Dr. Scheibe and her colleague rank the referral as expedited, intermediate concern, or low priority based on information provided by the referring clinician. “We mark those for our nurse to help schedule, and we let the referring provider know what the wait time is,” Dr. Scheibe said. “Then they have an opportunity to communicate back to us or say, ‘Yes, that’s fine,’ or, ‘I’m really worried about this patient. Could you get her in sooner?’ ”
Dr. Meghan Scheibe
It’s early in the process, but so far, implementation of the preconsult triage protocol “is allowing us to focus on the consultations on which we can be most impactful and not overwhelm the rheumatology workforce that we have,” she said.
Research reported in the UCSF study was supported by the American College of Rheumatology’s Ephraim P. Engleman Endowed Resident Research Preceptorship and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. None of the sources interviewed for this story reported having relevant financial disclosures.