Telephone triage of influenza-like illness during pandemic 2009 H1N1 in an obstetric population

• Published in: American journal of obstetrics and gynecology Vol. 207; no. 1; pp. 3 - 8
• Main Authors: Eppes, Catherine S., MD, Garcia, Patricia M., MD, MPH, Grobman, William A., MD, MBA
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-07-2012
• Subjects: Adult; Ambulatory Care - methods; Ambulatory Care - statistics & numerical data; Clinical Protocols; Efficiency, Organizational; Female; H1N1; Hospitalization - statistics & numerical data; Humans; influenza; Influenza A Virus, H1N1 Subtype; Influenza, Human - diagnosis; Influenza, Human - epidemiology; Influenza, Human - therapy; influenza-like illness; Obstetrics and Gynecology; Obstetrics and Gynecology Department, Hospital - organization & administration; Pandemics; Patient Safety; Pregnancy; Primary Health Care; Program Evaluation; Prospective Studies; Telemedicine; Telephone; triage; Triage - methods; influenza; influenza-like illness; H1N1; triage; pregnancy
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2012.02.023

We sought to determine the safety and efficiency of a telephone-based triage system for influenza-like illness, during the 2009 pandemic, at our institution. A triage system was implemented that involved initial telephone screening by a provider who determined whether outpatient telephone-based care or assessment in a centralized evaluation unit was needed. Those who received outpatient care were empirically treated. Those seen in the evaluation unit were assessed for inpatient admission. Of the 230 women who were evaluated, 41% were treated as outpatients and 59% were seen in the evaluation unit. Of those treated as outpatients, 9% were eventually seen in the evaluation unit and only 4% were ultimately admitted, with a maximum hospitalization of 4 days. Of the 135 patients initially seen in the evaluation unit, 32% were admitted and 44% had a positive polymerase chain reaction for respiratory pathogens. This triage system improved efficiency of resource utilization without incurring apparent influenza-like illness morbidity.