by Michelle Holztrager, RN

Tele-triage nursing has become a highly skilled and specialized field of nursing. At TeamHealth Medical Call Center we believe it is an art. We have found that the most successful tele-triage nurses excel in four areas: process skills; clinical knowledge; critical thinking; and listening skills.

Process skills consist of typing and keyboard / computer navigation skills. We utilize a number of tests to evaluate software comprehension, keyboard dexterity, typing speed and multitasking. Our nurses must access a number of different programs and client EMRs to meet client specifications and drive patient centered care. It is important that nurses are not defocused from patient interactions by difficulty managing technology.

The need for clinical knowledge is obvious and excellent phone assessment skills are paramount. Generally speaking, nurses with broad experience, in particular ER nurses, are a good fit for telephone triage. Ambulatory Care nurses usually have the benefit of previous in-patient experience coupled with phone assessments from their practice experience. For call center specialties and subspecialties, we seek nurses with the specific experience of the specialty area. TeamHealth Medical Call Center also provides intensive training on phone assessments, guideline selection, and the clinical phone triage process.

Adept critical thinking is another crucial attribute of a tele-triage nurse. A telephone nurse needs to be able to follow the triage process to do well. Deviating from the process and / or the guidelines will often result in poor decisions or the nurse going down the wrong path. A nurse with strong critical thinking skills can take in extra information and sort out the important nuggets without allowing the extraneous information to influence the call. Callers are usually subjective in their words and the tele-triage nurse must be able to separate the objective from the subjective and apply the triage process to the presenting facts.

Lastly, successful telephone triage requires excellent listening skills. There are no physical cues as to the patient’s disposition, thus the nurse is dependent on truly hearing and clarifying what the caller says. Listening skills, and hearing the important details, are vital to the process. At TeamHealth Medical Call Center, we train on listening skills and verbal indicators throughout our training program.

I like to say that the art of telephone triage is the science of nursing with specially trained listening skills. Nurses are used to physically multitasking, but tele-triage is very focused mental multitasking. Nurses who are proficient in these four areas will almost always shine in the field of telephone triage.


Michelle Holtztrager, TeamHealth Medical Call Center Leadership, Director of Education and Staff Development

Michelle Holtztrager, RN

Michelle Hoztrager, RN, is the Director of Education and Staff Development for TeamHealth Medical Call Center. She has twenty-five years of senior management experience in healthcare.

This article originally appeared in the October/November 2014 issue of Answerstat Magazine on page 21.