In the development of your appointment
policy and protocols, you will also need to consider triage and delegations.
A triage system allows identification of patients who require priority access
to the practitioner/treatment due to potentially serious/urgent
presentations. ( see “POPGUNS” resource )
A particular skill
required by front desk staff is the ability to prioritise, or triage patients –
whether this is by patient presentation at the practice or by referral from
another practitioner by phone, so that the sickest can be treated first.
Your protocol may be that all calls from another medical
practitioner about a referral are forwarded directly to the practitioner to
determine urgency and scheduling.
In a general practice, the staff may
be delegated the task of determining the urgency of ‘fit-in’ appointments. If
this is the case, the protocol would clearly state what complaints/symptoms
described by the patient are immediately referred to the general practitioner
or practice nurse (if employed) and when staff are expected to call for an
General practices that employ a practice nurse may decide to
transfer all callers with concerns immediately to the nurse for immediate
When patients present, they may also be triaged and, as
appropriate, directed immediately to the practice nurse/clinically trained
staff member and taken to a treatment room.
In larger practices it
may be that there is a nominated GP rostered to attend to urgent/walk-in
patients on a particular day.
Appointment systems should enable
prioritising of appointments, either labelling or colour-coding ‘urgent’
appointments so practitioners can easily determine the status of patients in
the waiting room.
If your expectations of your staff with regards to
triage do not match their qualifications and/or training, you are endangering
your patients and leaving your staff (and hence yourself) exposed.