# Presentation: 674717

## 24/7 Phone Triage Protocol for Public Health Departments

- Contact capacity requires an operator, typically untrained in public health, to receive and transfer each call
- received during nonbusiness hours.  This protocol was designed as a model that can be modified by state or
- local public health entities to define appropriate dispositions for incoming calls.
**PROTOCOL ATTRIBUTES**
- Ensure that defined categories of persons and institutions always reach the public health officer.
- Separate emergency medical care from public health.
- Identify illness or exposure requiring immediate public health action.
- Identify potential epidemic illness.
- Provide callers with non-urgent queries appropriate contact information.
- Create documentation of all public health calls for subsequent review and follow-up.
- Define a procedure for call-down and call transfer to a public health officer.

## NOTIFICATION OF INFORMATION CAPTURE  All callers who request to speak to the health department 

- (HD) or who appear to have a health or environmental concern should be told that the information about their call
- will be logged and this information will be provided to the health department on the next business day.
**CALL DOWN PROTOCOL A **
- The operator should attempt to connect the caller by using a warm transfer; however, if the caller
- requests to be called back instead of waiting on the line, the operator should confirm the phone number at which
- the caller can be reached during the next 30 minutes.
- The operator will contact the public health officer on first call by using the available technology in the
- order specified.  If no order is specified, then work, home, or cell phones will be used before pagers
- or other delayed response technology.
- 3.     If the public health officer on first call has not been reached within 5 minutes, the operator will
- attempt to contact the public health officer listed as second call.   While waiting for a response from
- the public health officer on second call, the operator will continue to attempt to contact the health officer
- on first call.
-  If the public health officer on second call has not been reached within 5 minutes, the operator will
- attempt to contact the public health officer on third call.
- The caller will be transferred to the first public health officer reached.
**CALL DOWN PROTOCOL B**  Same as A, except public health official returns call (cold transfer).
**TRANSFER TO ANSWERING MACHINE OR PROVISION OF CONTACT NUMBER**
- “May I transfer you to the appropriate office where you can leave your name and contact information for
- someone to contact you on the next business day, OR if you prefer, I can provide you the phone number of that office
- so that you can call back on the next business day?”
- 2.    Assess the acceptability of this option.  If caller seems upset, use call down protocol B.
**LOGGING**  For public health calls, name, organization, phone number, physical location and jurisdiction, reason
- for call, final protocol decision point, and disposition should be logged and the log provided to the health department
- on the next business day.

## 3

- Request for health department contact, or
- health department contact not requested but problem likely public health or environmental in nature.

- Is this a medical or mental
- health emergency?

- 911 or mental health

- Is the caller a:
- physician, dentist,
- veterinarian, media,
- hospital personnel,
- emergency agency,
- public health agency,
- CDC, or public official?

- Does the caller  wish to speak to the public health
- officer on call or leave a message?

- PH Officer

- Message

- P.H. call down protocol A

- Voice mail

- Yes

- No

- No

- Yes

- 1

- 2

- 4

- 3a

## 5

- No

- Is the caller calling because they or
- someone else is sick or injured?

- No or uncertain*

- Go to reference Chart H

- Have you or the person
- who is sick consulted with a
- physician?

- No

- Yes

- Refer to
- Hospital ED

- Public health call-down
- protocol A

- 5a

- Is the caller calling to get assistance
- with a chronic disease such as
- cancer or diabetes?

- Yes

- Is one person sick or
- more than one?

- More than one

- Yes

- 5b

- 5c

- Go to Question 6

- Public health call-down
- protocol A

- *Local option: Refer all to Protocol A

## 6

- someone else may have been recently
- exposed to something dangerous such
- as a contagious disease or chemical?

- No

- Yes

- Public health call-down
- protocol A

- Is the caller calling to get assistance with
-  an urgent environmental hazard such as a
- chemical spill or unknown powder?

- Yes

- Public Health
- Hazmat
- Law Enforcement
- (Local option)

- No

- 7

## 8

- particular disease?

- Yes

- Go to reference chart A

- No

- Is the caller calling about a problem
- related to food, water, sewage?

- No

- Go to reference chart B

- Yes

- 9

- FOR STATE HEALTH DEPARTMENT CALLS
- Follow state-local agreements for guidance on transfer to local jurisdiction.

## 10

- problems with health care  such as
- problems with medical care, child care,
-  or elder care?

- Go to reference chart C

- Is the caller calling because of problems
- with access to medical care or
- medications?

- Yes

- Yes

- Go to reference chart D

- No

- No

- Is the caller calling about an environmental
- nuisance such as garbage, flies, roaches,
- mosquitoes, rats, stray animals, mold, or dust?

- Yes

- Go to reference chart E

- 11

- 12

## 13

- restaurants or swimming pools?

- No

- Yes

- Go to reference chart F

- Is the caller calling about clinic
- schedules or for other general
- information?

- Yes

- Go to reference chart G

- No

- If the caller is calling about some other problem or concern not
- covered previously, go to public health call down procedure.

- 14

- 15

## Tuberculosis

- STD

- Report a case

- Call down protocol B

- Medication problem

- Call down protocol B

- Exposure

- Call down protocol B

- Report a case

- Exposure

- Information

- Condition

- Problem

- Response

- Other

- Call and leave No. at 111-1111

- HIV

- Report a case

- Medication problem

- Exposure

- Other

- Other

- Operator discretion

- Information

- Information

- Call and leave No. at 111-1111

- A

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Operator discretion

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Call down protocol B

- Call and leave No. at 111-1111

- Call down protocol B

## West Nile

- Report a case

- Dead bird

- Other

- Call down protocol B

- Information

- Animal Department for pickup

- Call and leave No. at 111-1111

- Operator discretion

- A

- Influenza

- Information

- Other

- Call and leave No. at 111-1111

- Operator discretion

- Rabies

- All calls

- Call down protocol A

- Smallpox

- All calls

- Call down protocol A

- Terrorism

- All calls

- Call down protocol A

- Other infectious disease

- All calls

- Call down protocol B

- Condition

- Problem

- Response

- Chronic disease

- All calls

- Go to reference chart H

- Chemical induced
- or other injury

- All calls

- Call down protocol A

- Report a case

- Call and leave No. at 111-1111

## B

- Food

- Contamination

- Information

- Call down protocol B

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Illness

- Call down protocol B

- Water

- Odor, color, appearance

- Information

- Water Department

- Water Department

- Other

- Operator discretion

- Illness

- Call down protocol B

- Sewage

- Illness

- Odor, backup

- Other

- Call down protocol B

- Information

- Sewer Department

- Sewer Department

- Operator discretion

- Condition

- Problem

- Response

## Condition

- Problem

- Response

- Child care

- Complaint

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Threat to life or health

- Call down protocol B

- Medical care

- Complaint

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Threat to life or health

- Call down protocol B

- Elder care

- Complaint

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Threat to life or health

- Call down protocol B

- C

## Condition

- Problem

- Response

- D

- Access

- HIV meds

- Immunizations

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- TB meds

- Call and leave No. at 111-1111

- HIV care

- Call and leave No. at 111-1111

- Need medical care

- Call and leave No. at 111-1111

- Complaint

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

## Condition

- Problem

- Response

- E

- Garbage

- Complaint

- Information

- Sanitation Department

- Sanitation Department

- Other

- Operator discretion

- Pickup

- Sanitation Department

- Flies, roaches, rats

- Information

- Other

- Call and leave No. at 111-1111

- Operator discretion

- Complaint

- Call and leave No. at 111-1111

- Mosquitoes

- Information

- Other

- Call and leave No. at 111-1111

- Operator discretion

- Complaint

- Call and leave No. at 111-1111

- Animals

- Bites

- Information

- Call down protocol A

- Animal Department

- Other

- Operator discretion

- Strays, endangered, dead

- Animal Department

## Condition

- Problem

- Response

- E

- Mold, dust

- Information

- Other

- Call and leave No. at 111-1111

- Operator discretion

- Complaint

- Call and leave No. at 111-1111

## Condition

- Problem

- Response

- F

- Restaurants

- Complaint

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Sick

- Call down protocol B

- Pools

- Complaint

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Sick

- Call down protocol B

## Condition

- Problem

- Response

- G

- General Info

- Employment

- Clinics

- Other

- Call and leave No. at 111-1111

- Locations

- Call and leave No. at 111-1111

- Provide

- Operator discretion

- Hours

- Provide

## Condition

- Problem

- Response

- H

- Chronic Disease

- Disease clusters

- Information

- Call and leave No. at 111-1111

- Call and leave No. at 111-1111

- Other

- Operator discretion

- Medical care

- No services at H.D.