• Bonnie Sommers-Olson, Jacqueline Christianson, Tonya Neumann, Scott A Pawlikowski, Storm L Morgan, Maria C Bouchard, Kristi S Esch, and Laura K Andrews.
• J Emerg Nurs. 2023 Jul 1; 49 (4): 539545539-545.

Study ObjectiveThe purpose of this quality improvement study was to reduce nonemergent visits to the emergency department attendance within a multistate Veterans Health Affairs network.MethodsTelephone triage protocols were developed and implemented for registered nurse staff to triage selected calls to a same-day telephonic or video virtual visit with a provider (physician or nurse practitioner). Calls, registered nurse triage dispositions, and provider visit dispositions were tracked for 3 months.ResultsThere were 1606 calls referred by registered nurses for provider visits. Of these, 192 were initially triaged as emergency department dispositions. Of these, 57.3% of calls that would have been referred to the emergency department were resolved via the virtual visit. Thirty-eight percent fewer calls were referred to the emergency department following licensed independent provider visit compared to the registered nurse triage.ConclusionTelephone triage services augmented by virtual provider visits may reduce emergency department disposition rates, resulting in fewer nonemergent patient presentations to the emergency department and reducing unnecessary emergency department overcrowding. Reducing nonemergent attendance to emergency departments can improve outcomes for patients with emergent dispositions.Copyright © 2023. Published by Elsevier Inc.

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