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Table 5 Assessment of percentage poor and relative risk (RR) of poor quality of health-related items for different triage professionals

From: Safety, efficiency and health-related quality of telephone triage conducted by general practitioners, nurses, or physicians in out-of-hours primary care: a quasi-experimental study using the Assessment of Quality in Telephone Triage (AQTT) to assess audio-recorded telephone calls

Health-related specific items (AQTT)Triage professionalNot applicablea
(%)
Poor quality % (n)RR for poor quality (95% CI)Adjusted RRc poor quality (95% CI)
1: Collects information about locationbGP70.732.3 (40)11
Nurse60.928.0 (47)0.87 (0.61–1.23)P = 0.430.91 (0.61–1.34) P = 0.62
Physician65.123.4 (36)0.72 (0.49–1.01) P = 0.100.75 (0.51–1.10) P = 0.142
2: Asks to speak to the patient when the caller has briefly described the situationbGP87.279.6 (43)11
Nurse85.854.1 (33)0.68 (0.52–0.89)* P = 0.010.71 (0.51–0.98)* P = 0.04
Physician83.973.2 (52)0.92 (0.76–1.12) P = 0.400.94 (0.75–1.17) P = 0.57
3: Identifies and acts appropriately on signs that could be critical or life-threatening for the patient (signs of problems according to the ABCDE criteria)GP73.542.9 (48)11
Nurse69.536.6 (48)0.85 (0.63–1.17) P = 0.320.74 (0.55–1.00) P = 0.05
Physician68.355.0 (77)1.28 (0.99–1.67) P = 0.061.31 (1.00–1.70)* P = 0.05
4: Identifies and uncovers problems, including symptoms and their developmentGP1.030.3 (127)11
Nurse0.519.9 (85)0.66 (0.52–0.83)* P = 0.000.61 (0.47–0.80)* P = 0.00
Physician0.234.1 (150)1.12 (0.93–1.37) P = 0.241.09 (0.89–1.34) P = 0.39
5: Identifies and states the purpose of the patient’s callGP20.324.3 (82)11
Nurse19.319.0 (66)0.78 (0.59–1.04) P = 0.090.76 (0.54–1.70) P = 0.12
Physician19.128.3 (101)1.16 (0.91–1.49) P = 0.241.14 (0.86–1.50) P = 0.37
6: Prioritises the presented problems and symptoms in an appropriate wayGP1.227.5 (115)11
Nurse0.525.9 (111)0.94 (0.75–1.18) P = 0.0.600.81 (0.63–1.03) P = 0.8
Physician1.837.6 (163)1.37 (1.12–1.67)* P = 0.001.28 (1.05–1.57)* P = 0.02
7: Asks, as a minimum, all the essential questions concerning the problem(s) and symptom(s) required for optimal triageGP0.535.9 (151)11
Nurse0.027.7 (119)0.77 (0.63–0.94)* P = 0.010.74 (0.59–0.93)* P = 0.01
Physician1.143.8 (191)1.22 (1.03–1.44)* P = 0.021.20 (1.01–1.42)* P = 0.04
8: Asks the relevant questions concerning previous medical history and medicationsGP32.249.5 (142)11
Nurse24.040.4 (132)0.82 (0.68–0.97)* P = 0.020.75 (0.61–0.91)* P = 0.00
Physician28.359.2 (187)1.20 (1.03–1.39)* P = 0.021.15 (0.98–1.34) P = 0.09
9: Gives relevant advice on self-careGP34.029.8 (83)11
Nurse52.135.0 (72)1.17 (0.91–1.52) P = 0.220.93 (0.71–1.22) P = 0.60
Physician38.642.1 (114)1.41 (1.13–1.78)* P = 0.001.30 (1.03–1.64)* P = 0.03
10: Gives relevant advice on safety nettingGP36.940.5 (108)11
Nurse55.434.4 (66)0.85 (0.67–1.08) P = 0.200.75 (0.58–0.97)* P = 0.03
Physician41.740.9 (105)1.01 (0.82–1.24) P = 0.930.98 (0.79–1.20) P = 0.81
  1. The RR for “poor quality” (i.e. “1” or “2”) was analysed using binomial regression model (GP as reference group). *Significant differences: p < 0.05
  2. aNot applicable was expected in a considerable proportion of cases, in line with the instructions for assessment in the guideline (see methods). We calculated the percentage of calls with “poor quality” (i.e. rated “1” or “2”) of all calls in which the item was relevant (i.e. “not applicable” excluded). bItems 1 and 2 were rated from “1” to “3”;
  3. c RR of poor quality adjusted for evaluator background (GPC, MH-1813) (i.e. if call is assessed by an assessor with the same professional background and organisation (similar-to-me)) and the uneven constitution of assessors (ratio assessors from GPC:MH-1813 – 16:8)