How the introduction of a specialist triage tool in a community palliative care setting impacts referral to review time and staff wellbeing.

Abstract

Background: At Walsall Healthcare NHS Trust, high referral volumes were overwhelming the community palliative care team, leading to delays in triage and patient contact alongside existing workloads. To improve this, a triage nurse role was introduced to assess and allocate new referrals, supported by a triage tool. This streamlined the review of clinical information and enabled timely telephone contact and appropriate clinical nurse specialist visits.

Aims: To enhance patient care by systematically evaluating clinical performance and attitudes towards the newly implemented triage tool, as well as assessing the team's wellbeing with a focus on reducing team pressure and redirecting the triage process.

Method: This clinical audit evaluated a service improvement initiative using a mixed-methods approach. An anonymous questionnaire was sent to the clinical nurse specialist and administrative teams to gather views on the triage tool. An audit of referral-to-first-contact times was also conducted using 20 randomly selected patient records (10 pre- and 10 post-implementation) from the team database. The audit was carried out by the care group quality nurse to reduce bias. Pre- and post-implementation groups were comparable, with no other significant service changes during the period.

Results: Results showed that using the triage tool improved the time from referral received to first patient contact, and supported team wellbeing through the process of clearly defining roles and responsibilities.

Conclusion: The implementation of a triage tool has enabled a more efficient and systematic method for prioritising patient referrals and allocating workload and resources equitably.