Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study.
Authors: Lightfoot Katie L, Burford John H, England Gary C W, Bowen I Mark, Freeman Sarah L
Journal: PloS one
Summary
# Editorial Summary: Telephone Triage for Equine Colic Telephone triage represents a critical gatekeeping function in veterinary practice, yet until this 2020 research, the approaches used to assess horses with suspected colic had never been formally investigated. Using participatory action research across UK equine practices, Katie Lightfoot and colleagues surveyed 116 veterinary professionals and interviewed reception teams to understand how colic cases were being triaged remotely and to identify inconsistencies in owner guidance. Reception and management staff demonstrated significantly lower confidence in recognising critical colic indicators and advising owners compared to veterinary surgeons and nurses (p = 0.03 and p <0.01 respectively), and the research revealed conflicting guidance being given to clients regarding exercise and owner safety—two themes appearing repeatedly across the survey responses. Rather than simply documenting these gaps, the team worked collaboratively with four practices to develop evidence-based resources including a decision flow chart and critical indicator information pack, which were implemented and evaluated six months later. Following implementation, client care staff reported increased confidence in both recognising critical cases and providing consistent owner advice, with the decision flow chart and critical indicator guidance proving most valuable in practice. For equine professionals involved in first-line telephone assessment—particularly reception staff who often field initial owner calls—these findings highlight the real need for standardised, accessible decision-making tools. Implementing structured resources could reduce variation in triage quality and owner advice, potentially improving case outcomes when every minute counts in acute colic situations.
Read the full abstract on PubMed
Practical Takeaways
- •Implement standardised telephone triage decision aids and critical indicator checklists in your practice—they demonstrably increase staff confidence and reduce conflicting advice to clients
- •Reception and client care staff require specific training and resources to confidently recognise and communicate about critical colic indicators, as they are significantly less confident than clinical staff without structured support
- •Develop written information packs and flow charts for your team to standardise colic triage responses and ensure owners receive consistent, evidence-based guidance regardless of who answers the phone
Key Findings
- •Client care staff felt significantly less confident giving owner advice and recognising critical colic indicators compared to veterinary surgeons and nurses (p<0.01 and p=0.03 respectively)
- •Conflicting guidance on colic management was frequently given by reception staff, with exercise and owner safety being most commonly mentioned topics
- •Decision flow charts and critical indicator resources increased staff confidence in recognising critical cases and providing owner advice following implementation
- •Sweating and recumbency were identified by reception staff as the most common signs of critical colic cases during telephone triage