Does a limited nurse triage service reduce junior doctor psychiatric on-call workload?

Abstract

Aims and Method. To investigate whether nurse triage might reduce junior doctors' on-call workloads in a general adult psychiatry in-patient unit, we measured changes in workload after the introduction of a limited (overnight and weekend mornings) nurse triage service on the unit, comparing pretriage work levels with levels 1 year later. This time frame allowed the new service to settle in, and controlled for seasonal variations in workload. Results. The number of 'work episodes' went up, especially during the night shifts, but the average length of each episode went down (both statistically significant, P<0.001). The net result was a slight increase in workload in terms of total time spent dealing with episodes, most notably at night. Clinical Implications. A limited overnight nurse triage service was ineffective on its own as a means of reducing the out-of-hours workload of junior doctors, and even slightly increased it. A more comprehensive triage service, with a greater range of alternatives to admission, might have had a different result.