Call center pleases patients, referring docs

Selling the service is part of the job

Because of the size of Boston's Brigham & Women's Hospital, patients or physicians calling to obtain a service sometimes had to speak to six or seven people before finding the one they needed, says Kerin Howard, RD, manager of teleservices.

That changed nearly three years ago with the advent of the teleservices department and a call center, known as the Physician Referral Service, that has received high marks from patients and physicians alike for improving access to the institution. "Patients really love the service - we've gotten several letters saying how helpful we were. And referring physicians compliment us often."

In the past, referring physicians felt they had sent patients into a black hole once they came to Brigham & Women's because of the difficulty in getting follow-up information, she says. Patients calling to make an appointment with a physician, schedule a medical screening, or obtain general information about hospital services faced a similar runaround.

Now patients call one number to make a physician's appointment, register for seminars Brigham & Women's offers through direct mail promotion, or get general information about everything from parking to scheduling a mammogram.

Physicians reach the call center through a different line and get higher priority from operators. "If three calls are waiting, the MD number would go to the top of the queue," Howard says. The MD number has been in a physician directory since 1991, she explains, but now calls are answered by an operator rather than voice mail.

Many want referrals

Between 80% and 85% of the callers are patients, and about half of them are looking for a primary care physician, Howard says. Another 20% want to see an ob-gyn, and the rest are split among the other specialty services. The 15% or 20% of the calls made by physicians are to schedule appointments for patients or to arrange consults with Brigham & Women's physicians. Data on call breakdowns are compiled from a record of all calls received.

The call center is open from 8 a.m. to 5:30 p.m. weekdays and is staffed by six FTEs and one manager. Two more FTEs have been included in next year's budget. "We had looked at having a 24-hour service, but the [call] data didn't support doing that. The only real need for a 24-hour service is if we had a nurse triage line, or if we were arranging critical care transfers."

There are no plans for a nurse triage line, she says, because Brigham & Women's parent company operates such a service. However, the hospital was scheduled to open a critical care transfer center beginning this month.

Originally under the supervision of the patient access department, the call center now reports to the vice president of the department of marketing and planning, Howard explains. That department was created about a year after the establishment of the teleservices department, but because of some of the services the call center provides, it "still overlaps with access," she adds.

The call center's employees handle just under 3,000 calls a month. "With six FTEs, that may not seem like a lot, but many of the calls are complicated, and there is the fulfillment part of the job." In addition to fielding calls from patients and physicians, for example, call center staff perform outbound services, such as sending patient discharge information to referring.

Howard handles much of the staff training, supplementing it with phone skills and customer servicing instruction from Bell Atlantic in Marlborough, MA, and the Boston offices of Dunn & Bradstreet, which is based in New Providence, NJ.

"I often have staff rotate through the ambulatory areas and observe, especially if the employee is an external hire," she says.

As call center employees have worked with callers to arrange services, they have made some surprising discoveries. For example, Brigham & Women's has opened a number of off-site primary care and ob-gyn clinics in the city's suburbs to make it easier for patients to access care.

But staff say many callers believe that to get the best medical care, they have to be on the hospital campus. Part of the job involves educa ting patients that the physicians they see 10 miles away are still affiliated with Brigham & Women's.

"They explain that if [the caller] wants to see a primary care physician [on the hospital campus], the wait could be six to eight weeks, but they could get an appointment in a week or two off-site," Howard says. "If someone lives in this community it makes sense, but if someone will drive past three or four primary care centers to get here, it doesn't." Of course, if the caller insists on coming to the main campus, the staff accommodate that request.

"The staff are in a sales position," she points out. "If somebody calls in and asks for a particular doctor, because someone gave them the name, [the call center employee] will say, 'We can get you in on this date, or you could see one of their colleagues sooner.'"