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TLC Call Center
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Saint Elizabeth
Telephone Line to Care
After-Hours Nurse Triage Program |
It’s all about relationships.
We at Saint Elizabeth know your patients have a trusting relationship with you.
And you have personal, caring connections to them and their families.
But we also know you want to spend more quality time with your own family or
need more down-time for yourself. We can help.
Start a working relationship with us.
We are the Telephone Line to Care (TLC) Call Center, based at Saint Elizabeth
Regional Medical Center, Lincon, NE. We have a team of RNs who currently help
more than 70 physicians not so different from you, to improve their own quality
of life with the comfort of knowing their patients are in caring, professional
hands should medical questions or emergencies arise. We provide after-business-hours
symptom management and health information for patients like yours.
Saint Elizabeth Telephone Line to Care has provided after-hours nurse triage
services since 1996. Our team of RNs currently serve 25 practices in Nebraska.
6 are Pediactric while the remaining 19 are Family Practice and other specialty
practices.
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Hours:
Monday through Thursday
5:00pm to 8:00am
Friday 4:00pm to 8:00am Monday
24-hour coverage
weekends and holidays |
References
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Calls are processed utilizing computer guidelines provided by McKesson Corporation with the objective of providing the right level of care at the right time. The guidelines were developed for use by registered nurses who comply with the respective Nursing Practice Act with the Rules and Regulations issued by each state. The guidelines recognize that a registered nurse will utilize knowledge and skill to make clinical decisions to manage each patient’s unique needs. Specific caller variables such as risk factors and distance from care can influence the recommended disposition and care advice.
nThe pediatric guidelines are developed by Dr. Barton Schmidt, MD. In 1994 he
wrote the first computerized pediatric triage protocols. His pediatric protocols
have become the standard of care for telephone triage in the United States.
nThe adult guidelines are managed by the Clinical Services department within McKesson.
Not a diagnosis
These guidelines do not diagnose disease or conditions. They help define actual or potential health problems that need further evaluation and facilitate initiation of an appropriate plan of care from a continuum of disposition options ranging from emergent care to home care. Triage guidelines should not be confused with practice standards and/or critical pathways intended to standardize medical diagnoses and clinical management.
These guidelines do not diagnose disease or conditions. They help define actual or potential health problems that need further evaluation and facilitate initiation of an appropriate plan of care from a continuum of disposition options ranging from emergent care to home care. Triage guidelines should not be confused with practice standards and/or critical pathways intended to standardize medical diagnoses and clinical management.
Updated
Guidelines are updated annually by a team of physicians contracting with McKesson with the intent to provide clinical content that is evidenced-based.
Guidelines are updated annually by a team of physicians contracting with McKesson with the intent to provide clinical content that is evidenced-based.
Guidelines are reviewed by our TLC nurses and the Medical Directors prior to implementation to ensure compliance with regional and local community standards. Any specific requests or changes noted by a physician are considered Provider Factors and become the standard for all of physicians within a practice. There are approximately 200 pediatric guidelines and 150 adult guidelines. Guidelines for pregnancy-related symptoms are not available in the system making them unavailable to nurses. Callers for these symptoms are referred to their obstetric provider.
How they work
Each guideline begins with an overview description and summary of key clinical points.
Each guideline begins with an overview description and summary of key clinical points.
Assessment questions asked by the nurse provide structure to the assessment process sequenced in to distinguish acuity of the presenting problem.
Clinical alerts are incorporated in the text of the guidelines. An alert is a clinically-pertinent fact providing more information such as significant risk factors to support disposition and care recommendations. An alert is also used to define or clarify clinical signs or symptoms to improve the reliability of how a question is asked. A clinical alert may also be helpful in convincing a reluctant caller to follow advice, expanding patient education, or providing rationale for upgrading a disposition.
Care advice is associated with individual assessment questions directed to the
caller’s described symptom(s) versus possible undiagnosed conditions. Specific
care advice is given after a recommended disposition is determined through the
nurse’s assessment.
NOTE: These care advice instructions are as succinct as possible to improve caller
retention of the most important information. The advice gives the caller or caregiver
a care plan to follow in lieu of or until the provider is seen.
At the end of each call, the nurse asks if the caller understands the information
given and if they will be able to carry out the instructions and this understanding
is documented in the patient’s record. Records are automatically faxed to the
provider’s office and may also be automatically faxed to a secondary location
if the patient is referred to the emergency department for continuum of care.
TLC Triage Program
nNurse Responsibilities
• Triage patient symptom calls using only approved McKesson HBOC Guidelines and/or Physician Provider Factors.
• Call or page physicians for further instructions as appropriate.
• Notify the patient’s preferred pharmacy for prescriptions per physician orders.
• Return follow-up calls to patients regarding physician’s orders or education.
• Fax report of symptom calls to physician’s office with 24 hours of the call.
• Automatically refer callers accessing TLC three times within a 24-hour period to the physician on call for second level triage.
• Facilitate callers with telephone access of their physician upon request.
nNurse Responsibilities
• Triage patient symptom calls using only approved McKesson HBOC Guidelines and/or Physician Provider Factors.
• Call or page physicians for further instructions as appropriate.
• Notify the patient’s preferred pharmacy for prescriptions per physician orders.
• Return follow-up calls to patients regarding physician’s orders or education.
• Fax report of symptom calls to physician’s office with 24 hours of the call.
• Automatically refer callers accessing TLC three times within a 24-hour period to the physician on call for second level triage.
• Facilitate callers with telephone access of their physician upon request.
nPhysician Responsibilities
• Determine by office, how patients will access TLC service.
• Determine by office, how patients will access TLC service.
• Inform patients about TLC service; hours of availability.
• Respond to TLC pages within 10-20 minutes.
• Fax physician call schedules monthly to TLC.
• Communicate changes to physician phone numbers, pagers, hours and/or new physicians joining the practice.
• Assure that all physicians in the practice are in agreement with and jointly sign requested guideline changes know as Provider Factors.
• Assure adequate paper and toner supply in the office fax machine for receipt of caller reports.
• Pay for service on a monthly basis in full.
Fees
Fees
You will be pleased to know our fees are competitively priced with similar services
in the region The service fee includes outbound calls to the physician for further instructions
or emergency care authorization; calls to the patient’s pharmacy for prescription orders; follow-up calls to patients
with physician’s orders and education; and calls to urgent and emergent care facilities with notification
of physician authorization. Provider calls include calls from a healthcare provider such as a physician, Emergency
Department, or Nursing Home.
Reports
Activity Reports and monthly invoices for services received during the prior
calendar month will be sent to physician practices by the 15th of each month.
Payments will be considered delinquent by the 15th of the following month.
Accessing Telephone Line to Care
We provide toll-free phone access for communities located outside the "402" area
code.
Care Topics Online
Saint Elizabeth has the top 85 pediatric topics which cover the most frequently encountered symptoms for children authored by Dr. Barton Schmitt on this website. They contain self-care guidelines for use by parents and care givers. You may recommend these to your patients for use from home or for your own nurses to use for patient calls during the business day.
Saint Elizabeth has the top 85 pediatric topics which cover the most frequently encountered symptoms for children authored by Dr. Barton Schmitt on this website. They contain self-care guidelines for use by parents and care givers. You may recommend these to your patients for use from home or for your own nurses to use for patient calls during the business day.