Described is the emergency triage referral system developed by a health maintenance organization. Based in an emergency department and staffed by emergency clinicians, this HMO triage system uses existing emergency medical services and enhances the delivery of prehospital care.

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Clinical triage at Harvard Community Health Plan.

Triage is the sorting of patients according to clinical urgency. The night-time triage program at the Health Centers Division of the Harvard Community Health Plan (HCHP) directs and coordinates all patient care. A thorough knowledge of the clinical and administrative program of HCHP as well as informed understanding of the external environment is necessary to accomplish this responsibility. As part of the orientation and training program for the night triage staff, a set of written clinical protocols for serious medical emergencies has been developed. Examples of clinical situations are provided in this article.

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After-hours telephone triage. Recruitment, training and retention of personnel.

Harvard Community Health Plan's nighttime telephone triage program, currently known as Telecommunications, has evolved through several stages, corresponding to HCHP membership growth, technological enhancements, and changes in the medicolegal environment. Recruiting, training, and retaining staff for nighttime telephone triage are discussed.

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