Phone Screening Script
- Raymonde Uy
[] = Action
() = Fill-in
Pre-Screening | identifying Target Screening Population
[Query electronic patient database / master patient index for target at-risk populations]
Risk Factors / Co-morbidities / Past Medical History
Table 1. COVID-19 Risk Factors / Co-morbidities / Past Medical History
Demographics | Elderly population |
Cardiology | Cardiovascular disease (e.g. Hypertension) |
Pulmonology | Asthma, COPD |
Gastroenterology | Liver disease |
Endocrinology | Diabetes |
Nephrology | Chronic kidney disease |
OBGYN | Pregnancy |
2. Recent visit (COVID-19 pandemic timeframe) with chief complaint or symptoms matching the following:
Table 2. COVID-19 Symptoms
Cough | Sore throat and related pharyngeal symptoms (odynophagia, dysphagia, hoarseness) | Sneezing
|
Fever | Headaches | Hypogeusia / Loss of taste |
Fatigue | Chills | Anosmia / Loss of smell |
Sputum production | Nasal congestion | Anorexia / Poor appetite |
Dyspnea / shortness of breath | Nausea / Vomiting |
|
Muscle aches | Diarrhea |
|
Table 3. COVID-19 Severe Signs and Symptoms
Severe dyspnea / shortness of breath at rest | Oliguria / decreased urine output |
Severe difficulty in breathing | Hemoptysis / blood in the sputum |
Moderate – severe chest pain or pressure | Nuchal rigidity / stiff neck |
Cold, clammy, pale or mottled skin | Acute onset of confusion |
Cyanosis of extremities or mucous membranes |
|
[Apply population health management: Prioritization via Risk Stratification methods (e.g. condition counts)]
Screening Initiation / Greeting
<If patient-initiated> “Thank you for calling ____________ (HCCN/CHC). How can I help you?”
<if provider-initiated> “Hi! My name is _______________. I am a (Title: MD/RN/NP/PA/MA, etc.) with (HCCN/CHC). How can I help you?”
(“How can I help you?” -> Chief Complaint)
If chief complaint is purely information-seeking, provide appropriate education *
[Confirm patient’s identity]
[Confirm patient’s location]
[Note patient’s phone number / contact information]
[Ensure patient’s privacy and informed consent]
** Rapid Assessment: Call 911 if the patient sounds very sick or distressed, then perform [EDUCATION]**
[EDUCATION]
Provide information using the CDC website and other sources for relevant local public health information.
Start Phone Triage and Clinical Evaluation
Chief Complaint: *Record as verbatim”
History of Present Illness
* Elicit Signs and Symptoms by using open-ended questions instead of specific/directed questions **
Cough Dyspnea |
|
Fever Chills |
|
Fatigue Muscle aches Shortness of Breath |
|
Headaches |
|
Sore throat and related pharyngeal symptoms (odynophagia, dysphagia, hoarseness) Nasal congestion Sneezing Anosmia / Loss of smell |
|
Nausea / Vomiting Diarrhea Hypogeusia / Loss of taste Anorexia / Poor appetite |
|
O – Onset (How / When did it happen?)
P – Provocation / Palliation (Is there anything that makes it better or worse?)
Q – Quality (Can you describe it for me?)
R – Region and Radiation (Where is the problem and does it radiate to any other part of the body?)
S – Severity (From a scale of 0 to 10, how severe do you think the problem is?)
T – Timing (Has it changed since it started? Is it better at different times of the day?)
[Ask questions specific to: Table 1. COVID-19 Risk Factors / Co-morbidities / Past Medical History]
Exposure and Contact Tracing
“Have contact with someone who was diagnosed with COVID-19?”
“Live in or visit a place where COVID-19 is spreading?”
Screen for special circumstances
“Do you/they live in a nursing home or other long-term care facility?”
“In the last two weeks have you/they worked or volunteered in a hospital, emergency room, clinic, medical office, ambulance service, first responder services, or any health care setting, or taken care of patients as a student as a part of your/their work?”
[Ask SDOH-related questions]
Disposition
[Use information provided by severity of symptoms, exposure, and co-morbidities to determine appropriate disposition.]