Identifying performance indicators to measure overall performance of telephone triage – a scoping review

This article aims to summarize performance indicators used in telephone triage services research, and make recommendations for the selection of valid indicators to measure the performance of telephone triage. We describe what kind of frameworks, performance indicators, or variables have been used for evaluating telephone triage performance by systematically mapping the telephone triage performance measurement. The objective was to find measures for each Triple Aim dimension. A scoping review method was used following Joanna Briggs Institute guidelines. Using this method, we defined indicators to measure the performance of telephone triage. We used the Triple Aim framework to identify indicators to measure the overall performance of telephone triage. The Triple Aim framework consists of improving the patient experience of care, improving the health of populations, and reducing cost per capita. The scoping review was performed using CINAHL, Medline, EBSCOhost, and PubMed electronic databases. The eligibility criterion was research published in English between 2015 and 2023. The inclusion focused on the use and performance of telephone triage services and system-focused studies. A total of 1098 papers were screened for inclusion, with 57 papers included in our review. We identified 13 performance indicators covering all Triple Aim dimensions: waiting times, access, patient satisfaction, the accuracy of triage decision, severity and urgency of the symptoms, triage response, patient compliance with the advice given, follow-up healthcare service use, and running costs of service. We didn’t find any earlier framework covering all Triple Aim dimensions properly. Measuring the performance of telephone triage requires an extensive and comprehensive approach. We presented performance indicators that may be included in the framework for measuring the performance of telephone triage to support overall performance measurements of telephone triage.

本研究旨在总结电话分诊（telephone triage）服务相关研究中所采用的绩效指标，并为遴选用于评估电话分诊服务绩效的有效指标提供建议。本研究通过系统梳理电话分诊绩效评估的现有实践，梳理了当前用于评估电话分诊绩效的各类框架、绩效指标及变量，目标是为三重目标（Triple Aim）的每个维度匹配对应的评估指标。本研究遵循乔安娜·布里格斯研究所（Joanna Briggs Institute）的指南，采用范围综述（scoping review）方法开展研究。依托该方法，本研究明确了用于评估电话分诊服务绩效的指标；并采用三重目标（Triple Aim）框架，确定了用于衡量电话分诊服务整体绩效的指标体系。三重目标框架包含三大维度：提升患者就医体验、改善人群健康水平，以及降低人均医疗成本。本次范围综述检索了CINAHL、Medline、EBSCOhost及PubMed等电子数据库，纳入标准为2015年至2023年间发表的英文研究文献，纳入研究聚焦于电话分诊服务的应用与绩效评估，以及聚焦于系统层面的相关研究。本次研究共筛选出1098篇符合要求的文献，最终纳入57篇文献进行综述分析。本研究共识别出覆盖三重目标所有维度的13项绩效指标，包括等待时长、服务可及性、患者满意度、分诊决策准确性、症状严重程度与紧急程度、分诊响应效率、患者对诊疗建议的依从性、随访医疗服务使用率以及服务运营成本。目前尚未发现能够完整覆盖三重目标所有维度的现有评估框架。电话分诊服务的绩效评估需要采用全面且系统的研究方法。本研究提出了可纳入电话分诊绩效评估框架的绩效指标体系，以期为电话分诊服务的整体绩效评估提供支撑。