Journal Article

DIALING UP THE SUPPORT: ENHANCING ACCESS TO CARE THROUGH IMPLEMENTATION OF AN ONCOLOGY NURSE TRIAGE SERVICE

Stanbery, Kim, O'Dell, Terena, Shore, Dena

2025

Overview

Significance & Background: As oncology care becomes increasingly complex, timely access to nurse triage for symptom management is crucial. Traditional models of assigning triage as an additional responsibility for the ambulatory care nurse often leads to delays and inefficiencies in addressing patient needs, which can impact patient outcomes and satisfaction. To address these challenges an oncology nurse triage service was proposed to increase patient access to care and enhance care delivery. Purpose: The purpose of this quality improvement (QI) initiative was to develop an innovative care delivery model, embed a digital workflow in the electronic medical record (EMR) and implement an oncology nurse triage service designed to improve patient access to care, across a large service area, while maximizing scope of practice for oncology nurses. Interventions: The QI project employed a multi-phased approach. Phase 1 included a comprehensive needs assessment, stakeholder engagement, and design of evidenced based triage protocols. In phase 2 the triage service model was developed and structured around a call center model, staffed with experienced oncology nurses trained in triage protocols. Key components of this project included building evidenced based triage protocols into the EHR for real-time patient information access and the development of standardized triage pathways based on clinical urgency and patient needs. The third phase involved training for all involved staff, establishment of performance metrics, and a phased rollout of the service across the service area. Metrics included volumes for incoming and outgoing calls, number of in-basket messages handled, response times and call abandon rate. Data was collected and analyzed over a six-month period to assess the impact of the new service. Results: The triage service has expanded to include five practices with plans to bring on three additional clinics by year end. Call volumes increased by 111% while maintaining service level targets for answering 80% of all calls within 60 seconds (m=82.59%) and call abandon rates decreased by 37% (m=3.45%). The integration with EHRs facilitated better continuity of care and more informed decision-making by triage nurses. Discussion: This project illustrates how implementing a dedicated triage service with standardized workflows and evidence-based algorithms can enhance timely patient access to care and ensure safe delivery of services. Future steps include ongoing program evaluation, symptom and disposition tracker, and exploration of expanded service capabilities to further optimize oncology care delivery.

• Publisher: Oncology Nursing Society
• Subject: Nurses / Oncology