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Applying Telephone Triage and Treatment to Acute Low Back Pain

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[Technical Report, Research Paper]

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Background In September 2017, William Beaumont Army Medical Center was below the 90 target for compliance with the Healthcare Effectiveness Data and Information Set measure for conducting imaging studies on acute, non-traumatic, low back pain. Unnecessary imaging increases the risk to patients, prolongs suffering, and increases the cost to the organization. Evidence revealed that conducting telephone triage is safe, accurate, directed to appropriate services, and has high patient satisfaction. Clinical Question In a military primary care clinic, does the implementation of pre-appointment triage, an automatic activity limiting profile, and prescription of non-steroidal anti-inflammatory medications for service members with acute, non-traumatic, low back pain improve patient management compared to pre-implementationProject Design From August 2019 until January 2020, patients were contacted by telephone before their scheduled appointment and an algorithm applied to their presenting illness. If the algorithm criteria were met, the patient was offered a CPG based treatment consisting of a temporary profile, medications, home exercises, and a referral to Physical Therapy. After thirty days of care, each patient completed a survey quantifying their management and perception of care. Analysis of the Results For fifteen patients managed with Telephone Triage and Treatment, the average wait time was reduced by two weeks. According to WBAMCs most current HEDIS data, the compliance rate for inappropriate imaging went from 67.9 in May of 2018 to 84 in October 2019. Post survey analysis reflects current literature data, to support telephone triage and treatment is safe, reduces wait time and has high patient satisfaction. Organizational ImpactImplications for Practice By implementing Telephone Triage and Treatment on a small scale, this project has proven its efficacy and can be easily adopted by any primary care clinic.

Subject Categories:

  • Medicine and Medical Research

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[A, Approved For Public Release]