Call Center Improvement Project CQI Team Members: Executive Leadership: Change Leaders: William Caplan MD – UWMF CQI Associate Medical Director Linda Drummond – UWMF CQI Lead Consultant Michael McGrew – UWMF CQI Lead Consultant Cheryl Andree - UWMF CQI Director Lori Hauschild, Richard Welnick MD Henny Regnier NP and Shelly Key RN
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Call Center Improvement Project CQI Team Members: Executive Leadership: Change Leaders: William Caplan MD – UWMF CQI Associate Medical Director Linda Drummond.
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Call Center Improvement Project
CQI Team Members:
Executive Leadership:
Change Leaders:
William Caplan MD – UWMF CQI Associate Medical Director
Linda Drummond – UWMF CQI Lead Consultant
Michael McGrew – UWMF CQI Lead Consultant
Cheryl Andree - UWMF CQI Director
Lori Hauschild, Richard Welnick MD
Henny Regnier NP and Shelly Key RN
• One of the larger primary care clinics in UW Health– 2 family medicine clinics merged to become Odana Clinic
in Spring 2007– 23 providers– Approx. 15,000 calls monthly
• Calls routed via two queues (based on patient selected call type)– Non-Clinical (Receptionists)
• Appointment scheduling• General clinic information
– Clinical (MA’s, LPN’s, and RN’s)• Symptomatic calls• Prescription renewals• Lab related calls
Project Description
2
• Phone abandonment rates at the clinic were higher than goal (3 - 5%)
– Average abandonment rates June 2007 to Dec 2007:
10% - Odana Clinic
4% - Overall UWMF
• Low patient and provider satisfaction with Communications Center performance
OA Monthly Abandonment Rate Comparison to all UWMF Automatic Call Distribution (ACD) Sites
(Monthly Averages: Mar - Dec '07)
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
Mar '07 Apr '07 May '07 Jun '07 Jul '07 Aug '07 Sep '07 Oct '07 Nov '07 Dec '07
• Reduce overall clinic telephone abandonment rate to 3% or below while maintaining call handling quality by August 2008
• Defined Project Metrics– Quantitative – Abandonment rate (AR), call
volumes
– Qualitative – Patient and provider satisfaction related to access to reaching clinic by phone
Project Goal
4
Anyone calls Clinic
Telephone Call Routing Process Map
Is call Clinical (CL) or Non-Clinical (NCL)?
Caller enters CL Queue
Caller enters NCL Queue
Receptionist answers call
Can Receptionist resolve call?
Call is resolved
Is call Clinical?
Is call for specific
provider?
NCLCL
No
No
Yes
CL Staff (MA) answers call
Call is transferred to CL Queue
Yes
Can CL Staff resolve call?
Is provider in?Call routed and
resolved by provider
Yes
Yes
Message left for Provider Call Back
No
Call routed/xferred as needed
No
Call is resolved
Call is transferred to Care Manager
(RN)
No
Yes
Can Care Manager (RN) resolve call?
Call is resolved Yes
No
Call routed to DOD or provider as
needed
Call routed to Dr’s Hotline
Is call from patient or Health Care
Representative?
Health Care Representative
Patient
Define “Current State”
5
• Current Situation Analysis– Literature review
• Medical Group Management Association
• Family Practice Management• International Customer
Management Institute– Best practice review
• Internal: After Hours Call Center• External: Kaiser-Permanente
– Root cause analysis • Brainstorming• Nominal voting
– Work system analysis• Process flows
– Data analysis• Call types and volume• Abandonment rate, queue times
• Conclusions– Call routing model
• Less than ideal– Current staffing
• Low FTE/call ratio • Misaligned staffing model mix• Open positions not filled
– Call routing• Non-clinical calls going to
Clinical Queue– Non-value added steps
• Potential for simplification– High volume of refill/lab results
calls– Staff unavailable
• Additional tasks preventing answering calls
Solution Development
6
Supply Management:Allocation of staff from existing FTE
• Receptionist moved to communications center
• RN Care Managers assigned to communications center
Optimized staffing to match demand• Moved “Lunch and Learn”• Balanced staffing to meet call
demand
Demand Management:Clinic welcome message revised
• 911 and Rx information moved to beginning of message
After hours message revised• To better route patients to
HealthLine
Improved efficiency for calls related to narcotic renewals
• Reinforced use of protocols
OA Monthly Abandonment Rate Comparison to all UWMF ACD Sites
(Monthly Averages: Jan - May '08)
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
Jan '08 Feb '08 Mar '08 April '08 May '08
Month
Ab
and
on
men
t Rat
e
Site
UWMF Clinics
Phase I
7
Phase II: Simulation
Model 1 Analysis:Eliminate communication center - all calls routed directly to clinical teams
Predicted costs:Information Services
system changesSalaries/benefits for
additional 6-8 Reception/MA/RN FTE
Construction costs for space re-allocation
Total of ~$315k increased cost
8
Phase 2: Simulation
Model 2 Analysis: Redesign existing telecommunications centerAll calls answered by dedicated receptionist pool, appropriate calls routed to clinical staff in
call center
Predicted costs: IS system changes + Salaries/benefits for additional 2-3 Reception/MA/RN FTE => Total of ~$125k increased cost9
Anyone calls Odana Atrium
Previous Telephone Call Routing Process Map
Is call Clinical (CL) or Non-Clinical (NCL)?
Caller enters CL Queue
Caller enters NCL Queue
Receptionist answers call
Can Receptionist resolve call?
Call is resolved
Is call Clinical?
Is call for specific
provider?
NCLCL
No
No
Yes
CL Staff (MA) answers call
Call is transferred to CL Queue
Yes
Can CL Staff resolve call?
Is provider in?Call routed and
resolved by provider
Yes
Yes
Message left for Provider Call Back
No
Call routed/xferred as needed
No
Call is resolved
Call is transferred to Care Manager
(RN)
No
Yes
Can Care Manager (RN) resolve call?
Call is resolved Yes
No
Call routed to DOD or provider as
needed
Call routed to Dr’s Hotline
Is call from patient or Health Care
Representative?
Health Care Representative
Patient
ANYONE calls Odana Atrium
Call is queued to Receptionists
Does call meet criteria to be resolved?
Call Resolved YES
TRANSFER to Neighborhood ‘Must Answer’ Line
Revised Call Routing Process Map
Call is answered by receptionist
MESSAGEYESDoes call meet criteria to be messaged?
Does call meet criteria to be transferred to Neighborhood?
NO
NO
YES
NO
Last Update: 6/4/08
Epic Neighborhood
Pool
Place Call in appropriate Communication Center
Clinical ACD Queue
Is call from patient or Health Care Representative?
Call routed to Dr’s Hotline
Health Care Representative
Patient
Call Handling Revision
-Old way: First Call Resolve
All calls routed to agent based on patient preference in automated selection menu
-New way: Best Call Resolve
All calls routed to receptionist, then routed as applicable based on patient needs
10
Jan to Aug 08 abandonment rate decreased from 13% to 1.3%
To date, still a top performer!
OA Monthly Abandonment Rate Comparison to all UWMF ACD Sites (Monthly Averages: Mar '07 - Aug '08)