Every call represents a patient care opportunity and a potential learning moment. Yet many triage programs operate in isolation, lacking multidisciplinary quality frameworks and safe spaces to discuss calls that didn’t go as planned. How can leaders create environments where quality review becomes a growth journey, instead of a critique?  

“We don’t regularly share with our peers, ‘We made a mistake. Let me tell you about it,’” says Kellyanne LaFrado, nurse manager for the After Hours Program at The Children’s Hospital of Philadelphia. “Instead, we typically share only the best practices, but that means we miss opportunities to learn from collective challenges.”

LaFrado says this approach creates a gap in quality improvement efforts. While medicine has developed robust safety forums in other high-risk areas (like Vascular access teams), contact center triage has remained fragmented, with each organization handling quality differently and often working in silos.

Building a culture where staff welcomes feedback begins with leadership vulnerability. One effective approach involves leaders sharing their calls for group review, LaFrado says. 

“It requires you to have the ability as a leader to say, ‘You know what? Even I don’t know how to do this perfectly.’ When clinical supervisors and staff who ‘grew up in triage’ acknowledge their growth opportunities, it creates a foundation for honest dialogue. This approach shifts quality review from a top-down assessment to a collaborative learning process.” 

Rather than keeping quality reviews confined to management, CHOP’s After Hours Program involves frontline staff in the process. Here’s how they structure the approach:

1. Regular group review sessions: LaFrado meets with her group of front line RN’s, leadership and medical director every two weeks. 
2. Structured, collaborative evaluation: “I have the list of calls I’m going to review in advance, but we listen to everything together,” LaFrado says. “Then, we use phrases like, ‘Here’s what went well’ and ‘Here’s your opportunity.’” 
3. Focus on behaviors, not scores: Staff responds better to “real actionable behaviors” instead of numerical scores. “For example, when documenting, avoid conflicting terms such as ‘no urine’ and ‘some urine’ because this can confuse the reader,” LaFrado says. “Try to be as specific as possible to maintain clarity in the chart.”  

Creating interprofessional psychologically safe spaces for quality improvement is one aspect of a larger need to elevate contact center triage as a clinical discipline. LaFrado says the field needs to develop more standardized approaches to continuing education, quality review and multidisciplinary collaboration.

“The future of contact center triage quality depends on creating spaces where teams can discuss not just successes, but also opportunities for improvement — where vulnerability is seen as a strength, not a liability,” LaFrado says.