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2 Offices
25 Physicians
2 Mid-level
Triage Department:
• 6 schedulers
• 25 nurses
• 680 calls per day
HOW MANY PHONE CALLS?
TREMENDOUS STAFF TIME
TOTAL STAFF TIME ON TELEPHONE EACH YEAR
• Answering calls
• Collecting Clinical Information
• Voicemails
• Outbound Calls
150,000
15,000 HOURS
6TRIAGE CALLS
OUR NURSE EXPERIENCE
VM VM VM
OTHER RESPONSIBILITIES OUR NURSES HAVE
Physical Exams
Blood draws
Fill orders
Care Coordination
Health HistoriesGive Medication
Chronic Care Management
See more patients
PATIENT EXPERIENCE WITH TELEPHONE
Our patient satisfaction scores for the telephone were getting worse.
NEW Workflow
GOALS AND OBJECTIVES
• Operations– Improve documentation of online
encounters
– Gather clinical information up-front
• Clinical– Reduce nurse time
– Standardize the encounters
• Patient Satisfaction– Give patients answers they need quickly
– Provide more avenues for access
• Administrative– Ramping up – maintain SLA
– Reduce nurse fatigue
– More performance reports
OPERATIONS
• Gave simple protocols to schedulers
• All calls follow standard process
• Schedulers gather basic triage information up-front
Non-Clinical Nurses Clinicians
Struggles• Summer call volumes jumped:
April: 9,000 callsJuly: 18,000 calls
• Handled 2x call volumes while implementing a new system –not an easy task!
• SLA’s – as calls spiked, so did dropped calls. SLA improved as we learned and implemented better processes.
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
0%
5%
10%
15%
20%
25%
30%
Call Volume vs Dropped
Calls
Dropped calls Call volume
Lessons Learned
• Don’t implement during your busiest telephone season!
• Don’t under-estimate training for front-desk staff
• Be transparent with your vendor – Keona was responsive
SUCCESS!
• Telephone satisfaction scores are higher – and rising
• Eliminated voicemail
• Reduced nurse burden• Our nurses are floor nurses
• No longer stationed by the telephone all day long!
• Have new metrics to track SLA’s• Total resolution time to encounters
• Time to conduct triage interview
• Implemented our own protocols
• Expanded system outside of clinical triage to billing
IMPLEMENTATION
Oakkar takes over.
Goal = 30 secs/slide
IMPLEMENTATION
Health Desk: 30-day Implementationafter Allscripts completes configuration
Kickoff Meeting
Submit Allscripts Ticket
Detailed discussion on call workflow
Meet marketing and IT
Determine responsible parties, review documentation forms
Software configuration based on client needs
Launch in production environment
Training provided to client
Client starts using software
Software & workflow adjustments
CUSTOMER SUCESS
• Workflow setup and
walkthrough
• Work with you to build new
features / protocols
• Assist with rolling out new
features and updates
• Provide suggestions for
maximizing ROI
Picture of Keona at
NFLWC here
Make telephone
protocols 6th grade
reading level and
non-clinical facing
ANATOMY OF A TRIAGE CALL
Intro Problem Vent Interview AssessmentRecom-
mendation
50-70% of call 30-50% of call
Patient or Front Desk Clinical Staff
50% less clinical time.
Time Saved
Appropriate
Care
Measured in National Institutes of Health Case Study in Partnership with University of North
Carolina – Chapel Hill
80% Prefer Online
Triage
Eliminate Voicemail
TOTAL
RESPONSE
TIME15 min. Patient
Satisfaction
?QUESTIONS
