The impact of a nursing triage line on the use of emergency department services in a military hospital

The purpose of this study was to evaluate the impact of nursing telephone triage on the appropriateness of emergency department (ED) use among 563 patients at a military hospital by comparing 286 ED patients referred by the Tel-a-Nurse Line (TAN) with 277 non-TAN-referred patients from October 2000 to November 2000. When controlling for confounding factors, TAN-referred patients had less appropriate ED use than non-TAN-referred patients, although this was not statistically significant (odds ratio = 0.87, p = 0.452). After excluding TAN patients with a primary clinic disposition but who were directed to the ED because no clinic appointments were available, TAN-referred patients had more appropriate referrals than non-TAN patients, although this was also not significant (odds ratio = 1.19, p = 0.401). TAN patients directed to the ED because of clinic appointment unavailability contributed significantly to inappropriate ED use with 62% having low acuity. This finding underscores the need to evaluate clinic availability for the TAN line and possibly for all patients as well.