Create a wonderful healthcare telephone experience!

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    23-Aug-2014
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Call centers can create better healthcare access with enterprise scheduling. Here is a live example of the process that created a call center that the medical and patient community found valuable!

Transcript of Create a wonderful healthcare telephone experience!

  • 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 T A R T U P
  • Call Center for Primary Care Patient Appointment Scheduling Medical Records Population Health Prior Authorization ReferralsTier I & II Care Coordination Informatics Patient Experience Transitions of Care Call Center A C K L E Y / C A L L C E N T E R S T A R T U P This project was one slice of a three year plan to develop a patient contact center.
  • Why a call center? Business value Singular branding Economies of scale Customer response Business alignment Standardized service Scheduling efficiency Competitive access advantage Remove white noise from the clinics A C K L E Y / C A L L C E N T E R S T A R T U P
  • Project scoping Create 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. Marks 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 T A R T U P
  • Starting point know your present state Antiquated phone system 75 PCP appointment types Labor pool talent challenges Lackluster hospital call center 19 different phone routing trees 23 different telephone numbers 23 different scheduling processes Trepidation from the provider community Patients struggle to navigate the system No 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 T A R T U P
  • Time sensitive Service standards Technology Management control Clinics lose control over their immediate schedule Community perception Communication between clinics and central scheduling Employee buy-in Physician buy-in Blending into hospital operations Easy Moderate DIFFICULT A C K L E Y / C A L L C E N T E R S T A R T U P Recognize the challenges
  • Know what success looks like Live answer Warm hand-offs Provider engagement Easy hospital transition Expanded scheduling hours Reduction in phone activity in the clinics Standardize customer telephone experience Quality control fill rate tracking, no shows, call backs Ultimately, 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 T A R T U P
  • PLANNING, COMMUNICATIONS & GOVERNANCE A C K L E Y / C A L L C E N T E R S T A R T U P 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.
  • 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 T A R T U P
  • Staffing Requirements: < 500 calls Targets and Assumptions: Average number of calls per day 326 calls Average call duration 76 seconds Average wrap up time 60 seconds Call answering target 80% in 20 seconds Trunk blocking target 0.010 Maximum agents 4 Lines 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 T A R T 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 day The 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 providers schedule has changed last minute. A C K L E Y / C A L L C E N T E R S T A R T 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. A C K L E Y / C A L L C E N T E R S T A R T U P 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!
  • Sequential go-live rollout Clinic 1 Clinic 2 Clinic 3 Clinic 4 Clinic 5 A C K L E Y / C A L L C E N T E R S T A R T U P 1. Debrief with clinic staff and providers 2. Share quality and performance metrics 3. Identify and resolve pain points 4. Invite staff next in the queue to debrief 5. Document all issues, resolutions and successes 6. Disseminate all information, network wide We continued the rollout in this manner and did not bring up the next clinic until all issues were resolved.
  • Measuring call volumes 0 100 200 300 400 500 600 CallVolume 1 clinic 5 clinics 153 532 A C K L E Y / C A L L C E N T E R S T A R T U P
  • Understanding peaks and valleys A C K L E Y / C A L L C E N T E R S T A R T U P 0 100 200 300 400 500 600 11/6/2013 11/8/2013 11/12/2 11/14/2 11/18/2 11/21/2 11/25/2 12/3/2013 12/5/2013 12/9/2013 12/11/2 12/13/2 12/17/2 12/19/2 12/23/2 12/26/2 12/30/2 1/2/2014 1/6/2014 1/8/2014 1/10/2014 1/14/2014 1/16/2014 1/20/2014 1/22/2014 1/24/2014 1/28/2014 1/30/214 2/3/2014 CallVolume Monday Average calls per day: 340 Start Monday Monday
  • Measuring quality A C K L E Y / C A L L C E N T E R S T A R T U P Quantitative 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 appointments Answer 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!
  • This is scalable Average number of calls per day 522 Average call duration 76 seconds Average wrap up time 60 seconds Call answering target 80% in 20 seconds Trunk blocking target 0.010 Maximum agents 5 Lines required 6 (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 T A R T U P 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.
  • There are no limits with smart growth Average number of calls per day 1,695 Average call duration 76 seconds Average wrap up time 60 seconds Call answering target 80% in 20 seconds Trunk blocking target 0.010 Maximum agents 11 Lines required 12 (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 T A R T U P Staffing requirement for a call center to manage over 1,500 calls per day and maintain industry standards at the 90th percentile.
  • Call center project final result Live answer Warm hand-offs Provider engagement Easy hospital transition Expanded scheduling hours Reduction in phone activity in the clinics Standardize customer telephone experience Quality 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 T A R T U P
  • Complete, successful and ready for the next slice! A C K L E Y / C A L L C E N T E R S T A R T U P