911 Emergencies
What are life-threatening symptoms that require an immediate 911 directive?
Choking
• Unable to wake (not responding)
• Having a stroke
• Not breathing
• Seizure (new onset)
What do we tell the RN when they answer?
Your name, with the ECC
• Patient’s name and DOB, and location
• Clinic and PCP name
• Reason they called and if it was fulfilled
• Red Flag Trigger Word symptom
What is the correct next step after identifying a non-911 red flag?
Warm transfer to ECC RN
What is the first step in the urgent red flag workflow?
Confirm the patient’s current location
What SmartText is used when a patient needs triage but the ECC RN is not available?
.imredflag
What is the approved scripting you must use when identifying a life-threatening situation?
“Based on what you are describing, this may be a medical emergency. Please hang up and dial 911. Can you confirm that you will do that?”
What do you do if patient is not established at ECC Clinic?
Locate clinic number and transfer patient to that clinic
What is the process for connecting a patient to triage?
Begin a conference call with ECC RN (385-622-0229)
What is required while waiting for RN connection?
Stay on the line and check back every 30–60 seconds
What priority level is required for all red flag SmartText messages?
Message priority set to High
What is the correct scripting if patient refuses to call 911?
“I understand. However your safety is important and we would advise that you hang up and dial 911. Can you confirm that you will do that?”
What steps do you take if patient is calling with suicidal ideation or a mental health crisis?
Begin the Mental Health Crisis Workflow, connect to Canyons ECC RN, option 2
What should you do if the RN did not answer in 3 minutes?
If RN does not answer in 3 minutes, Raise a Flag to escalate to a Lead
What is an important rule when connecting to triage?
Stay on hold with the PSC RN Triage line until the patient is connected with either the PSC RN or a clinical caregiver for triage.
Quickly check back with the patient every 30-60 seconds.
If the PSC RN answers and is on hold, they will only wait approximately 60 seconds before hanging up.
If the patient hangs up while waiting or when you are connecting with the PSC RN, give the callback information to the RN when they answer.
Do not send the ~imredflagnotification message to the PSC RN.
The PSR is responsible for creating a chart and Salesforce case if patient does not already have one
What is the subject line used for the standard red flag SmartText?
“Red Flag — Patient Triage Needed”
What action must be completed after directing a patient to call 911?
Sending an “immedflag911” SmartText after advising 911
When do you follow the URGENT Red Flag Workflow
When patient calls in to report Chest pain, Difficulty breathing, Fainting, New onset facial drooping, slurred speech, or difficulty speaking, Seizure, or Severe, uncontrolled bleeding
What is the correct after-hours escalation step?
Contact Physician’s Answering Service when clinic is closed
What is required if the patient hangs up during escalation?
Attempt to call the patient back twice. Leave a message during the first call attempt, stating that the call was disconnected and that you will call back shortly.
Do NOT leave any PHI or say why they had called or what you were speaking about.
“Hi, this is [Your Name] from [Clinic Name]. I believe I was just speaking with you, but the call disconnected. I will call you back again in just a moment.”
If the patient does not respond after the second attempt, send a high-priority ~immiscellaneous message to the physician/APP pool, detailing the Red Flag, the disconnection, and the attempts to reconnect.
What SmartText is used when a patient is referred to 911, the ER, or InstaCare?
.imredflag911
What is a high-risk scenario where you must restate the urgency, confirm understanding, and still complete escalation and documentation per workflow?
Patient refuses to call 911
“How should you proceed when a patient has red flag symptoms that are not considered urgent?”
Begin a conference call with ECC RN Triage: 385-622-0229 Choose option #3, if the RN is not available after 3 minutes send .imredflag message to the ECC Triage RN Pool and tell the patient “A nurse will be calling you back shortly. It may show as a an unknown or spam number, so please answer your phone.”
What do you do if the clinic is unable the call and advises you to tell the patient to go to ED/Instacare?
If the clinic is unable to accept the call and instead directs the PSR to advise the patient to go to the ED/IC or to schedule an appointment, the PSR should document this using the .imredflag911 SmartText
What do you do if the patient is not present but caller is telling you they are experiencing red flag symptoms?
If the patient is not present, follow the same triage workflow, but inform the caller that the nurse may only be able to give recommendations and things to watch for.
What information must be included when completing a red flag SmartText message?
Patient name, DOB, location, clinic/PCP, red flag symptoms, and reason for call