UC Davis

Objective: To evaluate the impact of a nurse triage unit responding and redirecting patient-initiated medical advice messages on primary care physicians’ workload at UC Davis Health Elk Grove Medical Group. The study evaluated physician time spent within In Basket during work hours and after work hours, both before and after the intervention. Materials and Methods All data was obtained through the Epic EMR Signal application. Data was collected two months before the pilot and two months post-pilot. Data was analyzed quantitatively through the paired t-test and the Wilcox Rank test. Statistical tests were performed on the data collected from the UC Davis Health Elk Grove clinic; and on a dataset that included additional data from the Folsom clinic in the UC Davis Health System. Results Neither the Wilcox Rank Test nor the Paired t-Test revealed a statistically significant difference in the amount of time spent In Basket during regular and after work hours before or after the intervention for physicians in Elk Grove clinic. In the secondary analysis that included data from Folsom, the Wilcox Rank Test revealed a significant difference in time spent In Basket during regular work hours and no significant difference in time spent In Basket after regular work hours. However, paired t-tests that compared the time spent In Basket for pre- and post-intervention at 30 days and 60 days did not reveal any significant difference for In Basket use during regular or after-work hours. Conclusions The UC Davis Elk Grove Nurse Triage pilot impact was not statistically significant and quantitative evaluation was not sufficient to identify the impact of the intervention on Primary Care Physician In Basket workload. Future studies should also include qualitative measure to evaluate intervention effectiveness as well as larger sample size.