How to Safely Redirect Patients Away from the Emergency Department


By Mark Dwyer

One of the most significant challenges hospitals faced over the past two years was handling the heightened number of ED calls and visits due to the COVID-19 pandemic. In many areas of the country, staff had to perform at heroic levels. And due to the ongoing variants, some are still facing tremendous challenges.

Having spent my career in the healthcare call center industry, I was pleased to see call centers across the country step up and field calls from millions of concerned individuals. However, much more is possible. 

Today’s call centers efficiently handle both clinical and non-clinical inbound and outbound calls. In addition, many accept text messages and bi-directional chats to facilitate patient access to care. These expanded communication options provided much-needed additional contact points during the pandemic. So, what other opportunities exist for the call center to play an even greater role? 

Front-Ending Clinical Calls

One such option is to position non-clinical agents to front-end clinical calls asking a brief set of questions to determine severity. Then, if the call meets any of four to five critical conditions pre-defined by the hospital, the front-ender passes the call off to a live Triage Nurse. If the call is determined to be less critical, it is placed into the nurses’ call-back queue for the next available nurse to process.

For decades, Triage Call Center nurses have used clinically proven protocols to guide callers, based on the severity of their symptoms, to the appropriate sources of care. In addition, the same clinical authors who wrote the Gold-Standard of triage protocols have added and revised multiple COVID-19 protocols and Care Advice over the past two years, enabling call center nurses also to triage COVID-19 patients. 

Now, the call center nurse can triage COVID-19 patients directing them to “call 911,” “go to the ED,” “Go to Urgent Care,” “See their PCP,” or provide home care instructions (among other endpoints). Doing so can redirect numerous patients to less urgent care options before they arrive at the ED unnecessarily. 

Follow-Up Options

After completing the triage portion of the call, if appropriate, the nurse can pass the call to a non-clinical call center agent to share directions to the referred facility, hours of operation, information on where to park, rules regarding caregivers accompanying the patient, and so forth.

If the patient requires admission to the ED, through integration to the hospital’s EMR system, the call center agent can keep the caregiver advised of the patient’s progress. This way, the agent can text the caregivers to update the patient’s status and discharge plans. In addition, when appropriate, the agent could either fax, text, or send by secure message any follow-up instructions for the patient.

The next day, the nurse or agent should call the patient or caregiver to make sure the patient filled any prescriptions they received, scheduled a follow-up appointment with their PCP, and followed other discharge instructions. Not only does this engender tremendous goodwill, but it often can be all that is needed to keep the patient from returning to the ED. 


To provide an effective integrated solution, the call center must work across the healthcare delivery system. It needs to team not only with its ED but also with area hospitals, emergent and urgent care centers, wellness and preventive care facilities, PCPs, and other services often needed by patients seeking care post-ED. If so, by creating a network of healthcare providers willing to accept and treat patients within reasonable timeframes, call centers can build trust in patients, so they are confident in the information and resources provided.

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Mark Dwyer is LVM Systems’ chief operations officer. He has more than a quarter century of experience in the healthcare call center industry.