Patients call to register for outpatient procedures

Phone banks save time, staff

Department-based registration phone banks at several hospitals in the Intermountain Health Care system streamline the outpatient experience for staff and patients, resulting in shorter wait times and greater efficiency.

Specially designated telephones in radiology, cardiology, rehabilitation, and physical therapy departments, among others, allow a centrally based staff to register patients over the phone. Patients are registered as they report for appointments in the ancillary areas, says John McBride, manager of admitting at Utah Valley Regional Medical Center, one of 23 facilities in the Salt Lake City-based health care system.

Phone kiosks do the work

The process works like this: The patient reports to the area, such as radiology, where he or she is scheduled for an appointment, and is immediately directed to a group of phones allocated for registration. The patient picks up a phone, which automatically dials a registration employee. The employee conducts the registration interview, much like in a face-to-face encounter. The registration form prints in the radiology department, and the patient signs it there.

The outpatient phone banks were instituted five years ago at Utah Valley to address two problems, McBride says. "We had four different registration areas to register patients for outpatient services. A lot of times, those registrars were not busy the whole eight hours, so we asked, 'How can we maximize their time?' Meanwhile, patients were reporting to the registration area, waiting there to be registered, and then walking to the appropriate department to receive a service. The question then became, "What will benefit both?"

At Utah Valley, where four registration employees handle the outpatient phone bank, the increased efficiency of the process resulted in the elimination of an FTE, McBride says. "It works really well and has been a very positive thing for patients because they go right to the department they're used to going to, and it's faster for us. When doing the interview in person, there's a lot of wasted time with chit-chat. Now [employees] do what needs to be done as quickly as they can."

Intermountain's three largest hospitals started using outpatient registration phone banks about two years ago, centralizing the process to serve the three facilities from one location, says Ladelle Hauck, manager of patient account services for LDS Hospital, Cottonwood Hospital, and Alta View Hospital, all in the Salt Lake City area. As part of her duties, she oversees preadmissions and admissions for the three hospitals.

Twenty-two employees staff the centralized phone bank, located at Cottonwood, with a maximum of 10 people on duty at any one time, Hauck adds. Phone bank staff can toggle into the computer systems of all three hospitals, registering patients directly into any of the three systems, she says.

"Right now, they handle about 1,200 phone calls a day, from 6:30 in the morning to 11 at night," she notes. "Some of those are us calling out [to preregister patients], but about half are incoming calls."

Getting ahead of the game

The extended hours allow staff to catch people at home to do preregistrations. "We try to preregister most of the patients a couple of days before the service, so we get the schedules from those sites and make the calls." And there are pediatric offices that are open that late. The phone banks also operate on weekends.

Staffing is adjusted according to workload, which she studied for six months to determine a pattern, Hauck explains. A couple of registrars are at work when the center opens at 6:30 a.m., and the number gradually builds, reaching the maximum of 10 at 4 p.m. Then it gradually decreases.

Automatic call distribution (ACD) reports from the telephone system tell Hauck the number of incoming and outgoing calls at various times, when employees are logged onto the system, when an extension is idle, and how long the calls last. Using that information, she adjusts staffing as needed. The goal is to keep calls to 3½ minutes. The ACD statistics are posted daily, so staff receive immediate feedback on how they're doing.

The hospitals' entire phone system, including that feature, is from Rolm Phone Systems in Santa Clara, CA.

"The quicker the process, the happier the patients are, and they perceive that it goes quicker [using the phone banks]," she says. "There is a lot of customer service training so the employees are kind and efficient as they go through the process."

Initially, patients didn't remember the long waits and walks to the lab they had experienced with traditional registration, and they felt the phone banks were less personal, Hauck says. That perception changed as patients got used to walking in and picking up the phone.

Works to patients' advantage

Most satisfied of all, she says, are the patients who have been preregistered during a call to their homes and have their paperwork waiting when they arrive for the appointment. "The more preadmits we can do, the better."

Before the phone bank went live, some of the registrars balked at being transferred to what they saw as an impersonal, data-entry job, Hauck points out. "They weren't sure they would like this work, and there was some turnover at first. It's important to remember staff needs. We try to give them some incentive by making the room as nice as possible, providing a window if we can. We show them the phone reports, and the surveys that show patients like it."

The phone banks gave the outpatient departments the added responsibility of handling the registration forms, which are picked up at the end of each day. But they also freed up the space formerly occupied by a registrar, as well as making the entire outpatient process move faster.

Ironically, the program didn't deliver on its initial goal of saving FTEs, Hauck says, because its popularity attracted more departments and services to participate. "We're about maxed at this point. We don't want to go above a certain wait time, so we're scrutinizing every request we get. We say, 'If you can give us another FTE, we'll take it on.'"