Abandoned calls cut from 13% to under 4%

Switch to centralized scheduling

By switching to a centralized approach to scheduling, patient access leaders at University of Kentucky (UK) Healthcare in Lexington reduced the phone call abandonment rate from 13% to under 4%.

"This reduction of the abandonment rate means we are able to serve approximately 270 more callers each day than we were four years ago," reports Lori S. Bruelheide, assistant director of enterprise patient access services.

Higher abandonment rates lead to frustrated patients and repeated phone calls. "Reducing this rate has many positive effects," she says. These steps were taken to achieve the lower abandonment rate:

• Managers evaluated the automated greetings on the phone lines that provide patients with choices.

"We wanted to make these as concise and consistent among clinics as possible," says Bruelheide.

In general, the "call trees" follow this standard model: Press 1 to schedule. Press 2 for a prescription refill. Press 3 to speak to a nurse. There are occasional additional options for other languages or a particular physician’s nurse.

"We still have some variances among specialties. But we strive to have no more than three options for each call tree," says Bruelheide. "This minimizes patient frustration and confusion."

• Managers worked with staff to reduce the average hold time to about 30 seconds before a live agent greets the caller.

"We have found that the abandonment rate is directly proportional to the hold time of the caller," says Bruelheide.

Easier scheduling

Several years ago, UK Healthcare’s patient access leaders became aware that patients were very dissatisfied with the scheduling process. In particular, the problem centered around the patient’s ease of obtaining an appointment — or lack thereof.

At that time, the department had multiple phone systems and a decentralized scheduling model. "This often resulted in patients being unable to determine how to reach the desired clinical area by telephone," says Bruelheide.

Patients found themselves being transferred within and between departments because they had called an incorrect phone number for scheduling. "Our decentralized scheduling model also led to understaffing of the scheduler positions in many areas," says Bruelheide. "Staff members had too many clinic responsibilities to devote sufficient time to scheduling."

In 2009, the organization developed a Patient Access Center to ease the process of scheduling appointments. The Patient Access Center schedules for 85% of ambulatory services and takes approximately 60,000 phone calls each month. "Our patient satisfaction with ease of obtaining an appointment, as reported on patient surveys, has risen dramatically during this time period," says Bruelheide.

Managers changed the job title of the individuals transitioning from the clinic scheduling role to the Patient Access Center scheduling role, from "patient relations assistant" to "customer access assistant." "This allowed us to rewrite the job description to focus on the scheduling aspect of the position," says Bruelheide. "We eliminated other front desk’ tasks, like medical records preparation."

Managers used the new job title to focus the efforts of the staff members solely on the incoming phone calls. "That, in turn, contributed to our improved hold times and abandonment rates," says Bruelheide. "These individuals no longer have to leave their phones to perform other tasks."

Fewer FTEs needed

Before switching to a centralized approach, scheduling at Cincinnati Children’s Hospital Medical Center was "completed in silos," says Chris Korneffel, director of scheduling center operations. Each department could schedule only its own specific services.

"Patients sometimes had to call multiple phone numbers or departments to schedule all of their treatments or needed services," says Korneffel.

There are now seven scheduling teams, with each comprised of three to seven departments, depending on the complexity of the scheduling. "This model allows scheduling with fewer FTEs than utilized prior to centralization, and the ability to answer more calls," says Korneffel.

Previously, a scheduler who worked in the orthopedic department only scheduled orthopedic services. After centralization, the scheduler now performs front-end scheduling processes for patients seeking services in allergy, pulmonary, international adoption, infectious disease and sports medicine, in addition to orthopedics.

The centralized call center now averages between 2,200 and 2,400 inbound calls per day, and 1,000 to 1,300 outbound calls per day. "Our average speed of answer is 37 seconds, our average abandon rate is 3%, and our average handle-time is 3 minutes and 45 seconds," says Korneffel. (See related stories on standardization of registration process, below, obtaining physician buy-in, p. 137, and improving patients’ ability to obtain an appointment, p. 137.)

SOURCES

• For more information on centralizing scheduling in patient access areas, contact:
• Lori S. Bruelheide, Assistant Director, Enterprise Patient Access Services, University of Kentucky Healthcare, Lexington. Phone: (859) 323-0772. Fax: (859) 323-2021. Email: lori.bruelheide@uky.edu.
• Chris Korneffel, Director, Scheduling Center Operations, Cincinnati (OH) Children’s Hospital Medical Center. Phone: (513) 636-5474. Email: Chris.Korneffel@cchmc.org.