On this episode of the WorkSAFE Podcast, we sit down with Lyndi Barthel, Manager of Medical Services and Case Management at MEM. Barthel has been with the company for nearly nine years. She has 28 years of experience in managing the medical aspect of work comp claims. At MEM, she oversees a team of talented professionals, along with the organization’s Nurse Triage program.
When it comes to work comp, a common saying rings true: an ounce of prevention is worth a pound of cure. The best way to ensure employees make it home safety every day is to prepare. However, injuries do happen. At the time of injury, choosing the right next step is crucial. A nurse triage program helps injured workers and their employers navigate what comes next, positively impacting medical outcomes and the claims process.
Listen to this episode on the WorkSAFE Podcast, or read the show notes below.
Nurse triage: The moments after an injury
For an injured worker, the best time to connect with nurse triage is right after an incident. “Many people may think of triage from watching old military programs, where individuals are prioritizing the injuries for an individual and the level of care that they require,” Barthel explained. Nurse triage, also called triage nursing, isn’t that different.
A group of nurses evaluate injured workers and their injuries. Their priority is to determine the best type of care they need at the time of the incident. “The primary goal of the nurse triage program is for the injured worker to seek and receive the right level of care in that moment.”
Support via telephonic nursing
Telephonic nursing is the ability to manage and asses an injured worker over the phone. Barthel highlights that this capability has come a long way over the years.
In the event of an incident, an injured worker (and their supervisor, if available) call an 800 number to connect with a nurse. The nurse will immediately ask several questions, including how the injury happened and what symptoms that are having. Their priority is to establish if it is an emergent situation, or one where 911 or other priority medical care is required. But if emergency care isn’t required, the nurse can open the door to other kinds of care, including:
- Telemedicine. This may look like a phone or video call with a physician.
- Self care. An injured worker might uses measures like rest, ice/heat, or elevating a injured limb.
MEM offers a nurse triage program, including a telephone line. Many industries operate outside of a 9-5 schedule, and having a 24/7 line benefits those working at all hours of the day and night. “This program is available 24 hours a day, seven days a week, 365 days a year,” Barthel explained. “There are always nurses there. They have them spread across the various time zones so that there will always be someone available to answer the call quickly.”
It also includes an added advantage for policyholders: a phone call with a nurse also serve as a first notice of loss. While the nurse triage line is not a claims reporting line – its purpose is purely medical – a claim is created and passed to the appropriate team for more information.
Choosing the right level of care with nurse expertise
If an injured worker has already seen a physician or been to the emergency room, then a triage call is no longer appropriate. And in emergency situations, especially when someone is non-responsive or not breathing, seeking immediate care is the right choice. However, treating less emergent injuries can benefit from a nurse’s expertise. For example, a back sprain or could be treated at home, through urgent care, or by an occupational physician. A nurse can help make the right call.
“These are highly trained nurses for this specific specialty of medical care, being a nurse triage individual,” Barthel explained. “They train for several years. They have a lot of experience in the area, and they’re following specific algorithms that are created.” Each question they ask leads them to more specific questions, designed to pinpoint the best patient outcomes. They aren’t coming up with treatment on the spot; they are following evidence-based guidelines to make the right decisions.
After a nurse triage call
After a triage nurse completes an assessment, they’ll provide instructions to the injured worker. These instructions might include care overnight and where to get medical care the following morning, if they can’t be seen the same day. Information will be sent to the provider, as well as an authorization, to ensure a smooth appointment.
Financial benefits of a nurse triage program
When a worker is injured on the job, employers can be quick to send them to the nearest emergency room or urgent care. But not all injuries require this. Costs can quickly add up, including the cost of care and time spent waiting to be seen. If a worker can care for themselves at home until the appropriate medical office opens up, or be directed to the best kind of care from the beginning, expenses are reduced and recovery outcomes are better.
Triage nurses can help set up a panel of preferred providers. For instance, they often can help identify the best nearby urgent care or occupational medicine facility. Then, when placing a call to a nurse triage line, injured workers can be directed to pre-selected medical care.
Taking the guesswork out of care
In the event of an incident – especially a serious injury – emotions run high. It can be difficult to think clearly and choose the next step. One of the major benefits of a nurse triage program is taking the guesswork out of getting the right care. In an emergency situation, seeking immediate care is always a good call. But where there are questions about how best to take care of an injury, a triage nurse provides invaluable guidance.