Case Study: QEII Health Sciences Centre's Communications System

By Jane Doucet

Winter, 2004

In 1996 six hospitals in Halifax, Nova Scotia, merged to become the Queen Elizabeth II Health Sciences Centre.  The largest adult academic health sciences center in Atlantic Canada, the QEII Health Sciences Centre occupies 10 buildings on two sites and provides tertiary and quaternary-care services for patients across Nova Scotia.  In 2000 it became part of the province's Capital District Health Authority (CDHA), an integrated health authority that covers a territory that stretches from Windsor to Sheet Harbour.

Before the merger each hospital was site specific.  After the merger, the QEII's staff expanded to 6,500 and administration of the formerly individual hospitals became centralized.  As a result, some logistical problems occurred; the amount of information flowing through the system doubled and systems that were operated manually in the past were now "impossible" to handle.

For example, Greg Jeans, the manager of Voice Services at CDHA, his colleague, Betty Bouchie, CDHA's voice administrator, and call center staff had to manually co-ordinate 200 different on-call schedules for 2,000 medical-staff members.  It was a nightmare.  According to Jeans, any print information became out of date as soon as a duty roster was posted and staff members inevitably would call in with schedule changes.  At one point it took three full-time employees to handle scheduling.  Keeping the rosters up to date was a time-consuming task and inaccurate information was often posted to some schedules.

In 1999 Jeans and Bouchie tried to create an internal system and database to address the problems, but soon realized the complexities to create this type of system were well beyond their capabilities.  They decided to take serious action researching communication strategies at other Canadian hospitals and examine supplier options in the marketplace.

Bouchie contacted the communications department of every major Canadian hospital and discovered that all of them were experiencing similar, if not worse, problems, as the QEII's.  She made a list of what she wanted a new system to do and began searching for the answer on the Web.  That's when she found an interesting system from a US based manufacturer.  After a Web/teleconference presentation, she was very interested.  In the spring of 2000, she found a hospital in New Hampshire that was using this product, the 1Call Infinity System produced by Wisconsin-based Amtelco, and paid them a visit.  After that, she knew it was exactly what her organization needed.

In October of 2002, 1Call went live at the QEII.  Prior to that date Bouchie, with a team of five, spent five months organizing and programming the relevant data into the system.  Initially, the transition was tough.  One of the biggest challenges was the resistance of the switchboard operators to embrace the new system, but 98% of the staff successfully made the transition to the 1Call Infinity System.

Today, the QEII's communications system links doctors, nurses, staff, and customers by providing a single source for information and communications from one location.  When connected as a call center or switchboard, information is presented to the operator on a PC screen in a consistent and logical manner, allowing operators to handle more calls in less time.  The system handles such things as patient and staff directories, on-call scheduling, call priority, distribution, statistical information, appointment scheduling and paging or locating services.

The system has improved efficiency notably.  With the old paper-driven system, only one operator could be trained at a time in a process that took approximately four months.  Now, two call center attendants or locators, as they are also called, can be instructed simultaneously in just five weeks.  Each of the 12 call center locator positions conduct all functions through the PC; answering, dialing, paging, messaging and call recording.

Although the QEII has been using the 1Call Infinity System for eleven months, they are not yet using it to its fullest capability; however its accuracy rate is significantly higher than the old paper system's rate of 95 percent.  Jeans hopes to reach maximum effectiveness in 2004.  A year after that, he expects to have received a full payback in operating-cost expenses followed by long-term savings while offering several new or improved messaging/information movement services supporting the Nova Scotia medical community.

Another advantage the system offers is accountability.  Since every call that comes in is recorded and monitored, when something goes wrong, it is possible to trace backward in the system to reveal the error.  For instance, the QEII's communications center acts as an internal 911 system, receiving and processing a wide variety of emergency response codes, for such things as fires, chemical spills, external disaster, and patient distress.  The system prioritizes all emergency calls, overriding any less urgent calls.

Any of the average 6,000 daily incoming calls the locators process can be thoroughly investigated.  Administrators find out who called, who answered the call and at what time, and what keystrokes were made in the process.  This can identify whether a problem was a communications error or the result of something else, like a pager that wasn't working.

While there have been some kinks in the system to iron out, the QEII's communications team hasn't been left to deal with them alone.  In the beginning, Amtelco's field-service technicians were called on regularly, but now only occasionally.  Jeans is impressed with the service the company provides.  He cites a hardware problem that was discovered 10 months after commissioning 1Call.  Amtelco sent a technician to fix the problem, armed with all new system hardware - at its own expense.

Now that the system has been operating for a year, QEII staffers wonder how they ever managed without it.  Many operators initially resisted implementing 1Call.  Now they believe a hospital even half the size of the QEII could not work efficiently without this tool.

This article is reprinted with permission from Longwoods Publishing Inc.