Safety on the Line - a short report on the development of a quality improvement model of nurse and GP helpline using simulated patients

Telephone triage and advice services (TTAS) operate in many countries to help manage demand for primary care and hospital emergency departments and improve access for those who experience barriers to obtaining healthcare. Simulated patients have been used to evaluate safety, appropriateness and adequacy of communication of TTAS. This short report presents a quality improvement model based on the simulated patient method that will be implemented in Australia’s national nurse and out of hours GP helpline in 2015. It consists of five steps: random selection of a subset of commonly presenting case scenarios with an uncommon level of acuity in some scenarios; an annual cycle of simulated patient calls presenting the selected scenarios; robust clinical and communications assessment using outcomes ascribed by a multidisciplinary Clinical Advisory Panel and clinical communication standards; rapid feedback to the service provider on strengths, weaknesses and gaps, and provision of targeted professional development and reflective practice opportunities for helpline clinicians. Implementing the model is expected to improve the safety and appropriateness of telephone health advice offered to Australian consumers.