MercyConnect Virtual Care
Chat Triage Reference Packet & Patient Encounter Summary
As of July 23, 2026
Compiled by: Dana Whitfield, Charge Nurse, Virtual Triage — for student triage nurse reference
Reference basis: This packet draws on the Schmitt-Thompson Clinical Content triage guidelines (accessed through the ClearTriage decision-support platform) and the SBAR documentation standard used across MercyConnect Virtual Care.
MercyConnect Virtual Care is a mid-sized telehealth provider serving three metropolitan health systems across the Midwest, handling roughly 4,000 patient contacts weekly across phone, video, and live chat. The newly launched live-chat channel now handles a fast-growing share of after-hours volume.
Confidentiality Notice: This document contains protected health information and internal clinical reference material. It is intended solely for authorized MercyConnect Virtual Care staff and student triage nurses. Do not distribute, copy, or disclose outside the care team.
Patient Encounter Summary
The following is a verbatim record of the opening exchange from an after-hours live-chat contact. It is presented as raw, partial data captured at the start of the encounter.
Encounter date/time: July 22, 2026, 11:42 PM (after-hours live chat)
Patient: 54-year-old female
Chief complaint: sudden, severe headache
Patient's opening message (verbatim):
"This is the worst headache I've ever had — it came on out of nowhere about two hours ago."
Additional lines captured during the opening exchange:
- Patient adds that her neck feels stiff.
- Patient reports feeling nauseated.
- Patient says bright light is bothering her eyes.
History offered by patient: Patient reports high blood pressure managed with medication; no prior history of migraines.
This is where the transcript pauses — the exchange above represents the initial contact only.
Triage Disposition Reference
Triage guidance follows the Schmitt-Thompson Clinical Content triage guidelines, accessed through the ClearTriage decision-support platform.
MercyConnect's adult triage protocols are supported by 36 adult disposition levels, ranging from Call EMS 911 (most urgent) to Home Care / Self-Care (least urgent).
Representative adult disposition levels (most to least urgent): (1) Call EMS 911 Now — activate emergency services immediately; (2) Go to ED Now (within 1 hour); (3) Go to ED / Urgent Care Now; (4) See Provider Within 4 Hours; (5) See Provider Within 24 Hours; (6) See Provider Within 3 Days; (7) Home Care / Self-Care with guidance.
The list above is a general reference to the shape of the disposition scale. It is not a mapping to any specific patient contact.
Red-Flag & Scope Guidance
This section is general reference material for all chat triage nurses.
Guiding principle: a triage nurse can't afford to be wrong — when urgency is uncertain, err on the side of caution and escalate.
Red-flag language and signs to listen for include: "worst headache of my life," sudden or "thunderclap" onset, stiff neck (with or without fever), chest pain or pressure, difficulty breathing, sudden weakness or numbness, confusion, slurred speech, or fainting.
RN scope of practice: triage nurses assess and route patients but do not diagnose conditions or prescribe treatment; when in doubt, escalate rather than advise beyond scope.
Chat channel note: nurses cannot hear vocal tone or see the patient, so severity, distress, and comprehension must be confirmed through careful wording and read-backs; typing delays and brief answers are common.
These items describe general patterns and boundaries. They do not characterize any individual encounter.
Documentation Standard
Every MercyConnect triage encounter is documented using the SBAR structure. The fields below are provided as a blank template reference.
SBAR documentation fields — Situation (why the patient is contacting care now), Background (relevant history and context), Assessment (your clinical interpretation and urgency), Recommendation (disposition, care advice, and safety-net instructions).
| SBAR Field | What it captures |
|---|---|
| S — Situation | Why the patient is contacting care now |
| B — Background | Relevant history and context |
| A — Assessment | Your clinical interpretation and urgency |
| R — Recommendation | Disposition, care advice, and safety-net instructions |
Safety-net closing standard: Every encounter must close with a safety-net instruction: tell the patient exactly what to do and when to seek higher-level care if symptoms worsen or new concerning signs develop.
This template is intentionally left blank. Completion for any specific contact is the responsibility of the assigned triage nurse.
End of reference packet. Questions may be directed to Dana Whitfield, Charge Nurse, Virtual Triage.