A supervisor says she received a complaint from a patient about rude treatment. She asks you, the registrar, whom the complaint is about, to listen to a recording of the call. Then, the supervisor asks if you think you provided good customer service.

This approach could lead the team member to become embarrassed and defensive — and could permanently damage the feedback loop between supervisor and employee, according to Denise Williams, COC, CHRI, senior vice president of revenue integrity services for Revant Solutions.

Some departments are using recorded calls for quality assurance differently. They are switching to a team approach. “We brainstorm as a group on appropriate responses when the customer’s voice is indicating frustration or agitation,” Williams explains.

After listening to a difficult call, the team discusses what could have been done better. “Sometimes, it’s just a matter of choosing a different word,” Williams observes.

Management always gives employees a heads-up before sharing a problematic phone call, since coworkers are likely to recognize one another’s voices. “This allows the team member to not be caught off guard with their less-than-stellar presentation,” Williams says.

Usually, the employee acknowledges that was a bad day, something everyone can relate to. “Then, the team discusses strategies they use on a bad day,” Williams adds.

Many recorded calls fall in the category of “moderately good” service. The calls start out OK, but end poorly. “It’s usually because the customer is upset about something, and the team member responds in kind,” Williams notes.

Staff may overhear a conversation that is going poorly in the next cubicle. Certain team members made a habit of standing and simply placing a hand on a stressed colleague’s shoulder. “The gesture was enough to let the one on the phone realize that their tone of voice is changing, and that someone has their back,” Williams explains.

Staff found a new way to do this even with social distancing. “They are helping each other via instant messaging,” Williams says. Coworkers send an emoji with sunglasses or a few words (such as “time for a cool-down”).

“The team worked out what each would say so that the recipient knew the context and watches for these reminders while on the phone,” Williams says.

If registrars are working remotely, they cannot hear each other’s calls. “However, they do have quick debriefing calls each day to talk about the calls that were frustrating,” Williams says.

Another creative technique has evolved. When a caller becomes irate, the team member politely asks him or her to hold for a moment to conduct a little research. The original team member asks a coworker to take over. “Together, the two team members briefly review the call to that point,” Williams says. “Then a ‘fresh’ person gets on the phone.”

Remote workers still can transfer tough calls to a willing colleague. They put the caller on hold, find out who is available, and give that person a heads-up that the call will be transferred to them. “A fresh voice is sometimes all that is required to get customer service back online,” Williams suggests.

At Arlington-based Texas Health Resources, patient access employees participate in “call labs.”

“A group of 10 gets together, with one call pulled from everybody in the room. Everyone learns from it,” says Alyssa McDonnold, CHAM, former director of the health system’s Patient Access Intake Center. Currently, McDonnold is patient access director at Maury Regional Health in Columbia, TN.

Feedback comes not from higher-ups, but from colleagues who perform the exact same jobs. “There’s something about having another person say, ‘I’ve had it happen to me, too,’” McDonnold says.

One recent call lab shared some examples of difficult interactions with people who could not pay their out-of-pocket liability. Instead of becoming defensive, staff really wanted to talk about the emotions involved with the calls. “The hardest part is trying to wrap it up in an hour because of all the interaction that happens,” McDonnold says.