Post on 23-Aug-2014
description
A C K L E Y / C A L L C E N T E R S TA RT U P
Scenario: Plan, design and create a call center for primary care appointment scheduling.
Improving the patient telephone experience…
A C K L E Y / C A L L C E N T E R S TA RT U P
Call Center for Primary Care Patient Appointment Scheduling
Medical Records
Population Health
Prior Authoriza-tion
Referrals
Tier I & IICare
Coordination
Informatics
Patient Ex-perience
Transitions of Care
Call Center
This project was one slice of a three year plan to develop a patient contact center.
A C K L E Y / C A L L C E N T E R S TA RT U P
Why a call center?
Business valueSingular brandingEconomies of scaleCustomer responseBusiness alignmentStandardized service Scheduling efficiencyCompetitive access advantageRemove white noise from the clinics
A C K L E Y / C A L L C E N T E R S TA RT U P
Project scopingCreate a call center for enterprise primary care scheduling.
• 5 adult medicine primary care clinics and 1 urgent care center• 500 phone calls per day (estimated)• 28 providers
Do this in a manner that creates better access and a singular telephone experience for patients in the community.
Mark’s rules of engagement:
• Must be scalable.• Must be sustainable.• Remain FTE budget neutral.• Must use existing technology.• Incorporate Lean principles and techniques. • Must clearly demonstrate value to both patients and medical providers.
A C K L E Y / C A L L C E N T E R S TA RT U P
Starting point – know your present state
Antiquated phone system75 PCP appointment typesLabor pool talent challengesLackluster hospital call center19 different phone routing trees23 different telephone numbers23 different scheduling processesTrepidation from the provider communityPatients struggle to navigate the systemNo consistency in the patient telephone experience Long wait times to schedule an appointment inhibiting patient access
A C K L E Y / C A L L C E N T E R S TA RT U P
Time sensitiveService standardsTechnologyManagement controlClinics lose control over their immediate scheduleCommunity perceptionCommunication between clinics and central schedulingEmployee buy-inPhysician buy-inBlending into hospital operations
EasyModerateDIFFICULT
Recognize the challenges
A C K L E Y / C A L L C E N T E R S TA RT U P
Know what success looks like…
Live answerWarm hand-offs Provider engagementEasy hospital transitionExpanded scheduling hoursReduction in phone activity in the clinicsStandardize customer telephone experienceQuality control – fill rate tracking, no shows, call backsUltimately, one number to call for medical services in
Santa Fe
A C K L E Y / C A L L C E N T E R S TA RT U P
PLANNING, COMMUNICATIONS & GOVERNANCE
Steering Committee
Clinical leadership
Operations Committee
Technology Committee
Clinic Committee
Consulting Services
• Weekly meetings• Constant feedback loops• Quality metrics published• Communication to clinics• Go-no go status for every
phase• All meetings open to
anyone
Planning and communications were the key components. This project demanded a high degree of discipline in project management, communication and transparency for every stakeholder in the network.
A C K L E Y / C A L L C E N T E R S TA RT U P
Basic requirements for call center start up
Quality metrics and and agent monitoring.Provider scheduling targets and preferences.Standard answering and hand-off techniques.Telephone savvy, bi-lingual, telephone agents.Telephone routing protocols for warm hand-offs. Quiet office space with minimal background noise. Workstation cubicles with minimum of 36 square feet.Technology – computer, phone, headset, 2 large monitors.Instant messaging for communication between clinic and call center.
A C K L E Y / C A L L C E N T E R S TA RT U P
Staffing Requirements: < 500 calls
Targets and Assumptions: Average number of calls per day
326 calls
Average call duration 76 secondsAverage wrap up time 60 secondsCall answering target 80% in 20 secondsTrunk blocking target 0.010Maximum agents 4Lines required 5
(Based on Erlang B and Erlang C Traffic Models)
A C K L E Y / C A L L C E N T E R S TA RT U P
Start up call center staffing
3 agents processing an average of 326 calls per day 326 calls per day = 4.4 working hours per agent per dayThe remaining 3.6 hours in an 8 hour work day
(1.0) hr for lunch and breaks 2.6 hrs used for:
appointment reminders, processing notes, entering and updating patient information, transferring calls to office staff, rescheduling appointments if the provider’s schedule has changed last minute.
A C K L E Y / C A L L C E N T E R S TA RT U P
Call center “go-live” strategy Tactical Choice – I used a “soft launch” approach and pointed all
existing phone lines to the central location making it invisible to the patient. The patient was calling “their clinic” and did not know the difference except for the increase in service and access.
We even did our best to match the call that was routed from the clinic to the agent who came from that clinic – it turns out that the patient did not care, they were just happy with the access!
A C K L E Y / C A L L C E N T E R S TA RT U P
Sequential go-live rollout
Clinic 1
Clinic 2
Clinic 3
Clinic 4
Clinic 5
1. Debrief with clinic staff and providers2. Share quality and performance metrics3. Identify and resolve pain points4. Invite staff next in the queue to debrief5. Document all issues, resolutions and
successes6. Disseminate all information, network
wideWe continued the rollout in this manner and did not bring up the next clinic until all issues were resolved.
A C K L E Y / C A L L C E N T E R S TA RT U P
Measuring call volumes
11/6/
2013
11/7/
2013
11/8/
2013
11/9/
2013
11/10
/2013
11/11
/2013
11/12
/2013
11/13
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11/14
/2013
11/15
/2013
11/16
/2013
11/17
/2013
11/18
/2013
11/19
/2013
11/20
/2013
11/21
/2013
11/22
/2013
11/23
/2013
11/24
/2013
11/25
/2013
11/26
/2013
11/27
/2013
11/28
/2013
11/29
/2013
11/30
/2013
12/1/
2013
12/2/
2013
0
100
200
300
400
500
600
Cal
l Vol
ume 1 clinic
5 clinics live
153
532
A C K L E Y / C A L L C E N T E R S TA RT U P
Understanding peaks and valleys11
/6/2
013
11/8
/201
311
/12/
...11
/14/
...11
/18/
...11
/21/
...11
/25/
...12
/3/2
013
12/5
/201
312
/9/2
013
12/1
1/...
12/1
3/...
12/1
7/...
12/1
9/...
12/2
3/...
12/2
6/...
12/3
0/...
1/2/
2014
1/6/
2014
1/8/
2014
1/10
/201
41/
14/2
014
1/16
/201
41/
20/2
014
1/22
/201
41/
24/2
014
1/28
/201
41/
30/2
142/
3/20
14
0
100
200
300
400
500
600
Call
Volu
me
Monday
Average calls per day: 340
Start!
MondayMonday
A C K L E Y / C A L L C E N T E R S TA RT U P
Measuring qualityQuantitative
Dropped call rate < 2% Schedule fill rates have increased from 74% to 92%Average talk time increased from 45 seconds to 90 seconds. Call center is now scheduling 90% of all PCP appointmentsAnswer time = 3 seconds, post router message per ACD reports
Qualitative
Positive feedback from providers “Hey, this works!”Clinic noise level reduced to create quiet, calm spaces.Front office staff report they can focus on the patient in front of them.Positive feedback from the Patient Advisory Council “Thank you for listening!”
“Finally, I can schedule an appointment to see a Physician faster, talk to a live person and only have to dial one phone number!”
A C K L E Y / C A L L C E N T E R S TA RT U P
This is scalable
Average number of calls per day
522
Average call duration 76 secondsAverage wrap up time 60 secondsCall answering target 80% in 20 secondsTrunk blocking target 0.010Maximum agents 5Lines required 6
(Based on Erlang B and Erlang C Traffic Models)
Using national call center industry standards, you can use Lean “load leveling” techniques to balance your resources against your need.
Growing your business? No problem, here is what you need to manage your phone traffic.
A C K L E Y / C A L L C E N T E R S TA RT U P
There are no limits with smart growth
Average number of calls per day
1,695
Average call duration 76 secondsAverage wrap up time 60 secondsCall answering target 80% in 20 secondsTrunk blocking target 0.010Maximum agents 11Lines required 12
(Based on Erlang B and Erlang C Traffic Models)
Staffing requirement for a call center to manage over 1,500 calls per day and maintain industry standards at the 90th percentile.
A C K L E Y / C A L L C E N T E R S TA RT U P
Call center project – final result
Live answerWarm hand-offs Provider engagementEasy hospital transitionExpanded scheduling hoursReduction in phone activity in the clinicsStandardize customer telephone experienceQuality control – fill rate tracking, no shows, call
backs
✔✔✔✔✔✔✔✔
A C K L E Y / C A L L C E N T E R S TA RT U P
Complete, successful and ready for the next slice!