Escalation Framework

Our personnel do not assess symptoms, evaluate urgency, or give clinical advice. When a matter falls outside administrative scope, they collect information on the approved form, route it as the client has directed, and relay the client's response verbatim.

Emergency instructions override all other routing. Our personnel do not evaluate whether a situation is a genuine emergency. If the caller indicates an emergency, it is treated as one.

Medical emergencies are directed to 911. Mental health crises are directed to 988 or to the client's stated instruction. The client's on-call contact is notified in either case.

Each of the following is routed to the contact and within the timeframe the client specifies in its Escalation Protocol:

• symptom or condition questions;
• medication questions;
• refill requests;
• test or lab result inquiries;
• triggered aftercare flags;
• complaints;
• anything not listed above.

Clients define objective patient responses that route immediately. Triggers are stated as facts rather than judgments, for example "patient reports temperature above 101" rather than "patient sounds unwell". Our personnel apply the rule and do not evaluate clinical significance.

Clients approve the exact wording used with a patient while awaiting a response. Our personnel use that wording verbatim, without addition.

Every escalation is logged with the time raised, the category, the person contacted, the channel used, the time of response, and the instruction relayed. Logs are available on request and are reviewed at each account review.