As we welcome 2026, it’s the perfect time to look back at the most utilized ClearTriage telephone triage protocols of 2025. Continuing from our analyses of the top protocols in 2023 and 2024, we’ve compiled data from all active ClearTriage accounts and sorted protocols based on the number of times each was copied into the patient’s medical record.
For this year’s list, we once again combined the usage of After Hours and Office Hours protocols to present a comprehensive view of the reasons for both pediatric and adult calls.
While many protocols in the Top 20 remain consistent across After Hours and Office Hours usage, there are notable differences in their ordering and a few unique entries in each list. To take a closer look at these variations, check out the individual Top 20 lists for After Hours Pediatric Protocols, After Hours Adult Protocols, and their Office Hours counterparts using the links below.
• Pediatric Calls: The Top 20 protocols accounted for 52% of all pediatric protocol usage in 2025, consistent with recent years.
• Adult Calls: The Top 20 protocols made up over 39% of all adult protocol usage in 2025, again consistent with recent trends.
Observations From the 2025 Data
Looking across three years of protocol usage reveals several notable patterns that help explain how patient needs — and the role of the telephone triage nurse — continue to evolve.
COVID has transitioned from a dominant symptom to a situational concern.
In 2023, COVID-related protocols ranked among the most frequently used across all adult and pediatric settings. By 2025, COVID appears in the top 20 only in After Hours Pediatric usage, and even there at a much lower percentage. This gradual decline highlights a shift toward more stable, predictable triage demand, as pandemic-driven call patterns continue to fade.
After-hours adult triage is increasingly focused on ongoing care management.
Medication questions, refills, and blood pressure concerns have steadily risen in prominence in After Hours Adult calls. In addition to being driven by acute symptoms, after-hours adult triage more frequently involves supporting patients managing chronic conditions when traditional healthcare locations are closed.
Pediatric demand remains stable — and highly predictable.
Across both Office Hours and After Hours Pediatric calls, the same core concerns continue to dominate: cough, fever, gastrointestinal symptoms, rashes, and ear-related complaints. This predictable pattern underscores the value of maintaining clear, evidence-based pediatric protocols for the most common respiratory and viral presentations.
Call volume is spreading beyond the “Top 20.”
While the Top 20 protocols still account for a significant share of usage, their overall concentration has gradually declined since 2023. This suggests that triage nurses are navigating a wider range of patient concerns, reinforcing the need for broad protocol coverage and strong clinical decision-making skills.
Want to see how this year’s data compares to previous years? Take a look at last year’s blog post on the Top 20 ClearTriage Telephone Triage Protocols of 2024 to learn more.
Top 20 Pediatric Protocols Used in 2025
- Cough – 10.6%
- Fever – 3 Months or Older – 5.8%
- Vomiting Without Diarrhea- 3.9%
- Sore Throat – 2.7%
- Constipation – 2.7%
- Diarrhea – 2.5%
- Head Injury – 2.5%
- Medication Question Call – 2.2%
- Earache – 2.1%
- Rash or Redness – Widespread – 2.0%
- Colds Without Cough – 1.9%
- Rash or Redness – Localized – 1.8%
- Eye – Pus Or Discharge – 1.7%
- Vomiting With Diarrhea – 1.7%
- Hand-Foot-Mouth Disease – 1.6%
- Immunization Reactions – 1.5%
- Influenza (Flu) – Suspected – 1.2%
- Abdominal Pain – Female – 1.2%
- Diaper Rash – 1.1%
- Sinus Pain or Congestion – 1.1%
2025 Top 20 Protocols – Office Hours Pediatric PDF
2025 Top 20 Protocols – After Hours Pediatric PDF
Top 20 Adult Protocols Used in 2025
- Cough – 5.1%
- Urinary Symptoms – 3.0%
- Blood Pressure – High – 2.8%
- Back Pain – 2.4%
- Chest Pain – 2.4%
- Medication Question Call – 2.4%
- Abdominal Pain – Female – 2.2%
- Sore Throat – 2.0%
- Breathing Difficulty – 1.8%
- Headache – 1.8%
- Sinus Pain or Congestion – 1.7%
- Dizziness – 1.7%
- Diarrhea – 1.6%
- Medication Refill and Renewal Call – 1.5%
- Leg Swelling and Edema – 1.3%
- Heart Rate and Heartbeat Questions – 1.3%
- Rash or Redness – Localized – 1.3%
- Leg Pain – 1.2%
- Common Cold – 1.2%
- Weakness (Generalized) and Fatigue – 1.1%
2025 Top 20 Protocols – Office Hours Adult PDF
2025 Top 20 Protocols – After Hours Adult PDF
Which Protocols Do My Nurses Use?
ClearTriage includes self-service reporting at no additional cost. To see how your organization compares, run the Protocols Used report in ClearTriage Admin. Click here to see a full list and description of all of the reports available in ClearTriage.
ClearTriage is a web-based decision support tool for telephone triage nurses and the leading provider of the Schmitt-Thompson telephone triage protocols. Start your 30-day free trial today!
