Case Study: Children's Healthcare of Atlanta

By Darin Southard

August/September 2008

Children's Healthcare of Atlanta (Children's) is a not for profit organization that strives to enhance the lives of children through excellence in patient care, research, and education.  From performing liver transplants and helping patients keep up with their schoolwork, to building urgent care clinics in convenient locations, it supports children's health needs by defining, then providing or advocating for accessible, innovative, and excellent patient care. 

In January 2008, Children's was ranked among FORTUNE magazine's elite list of "100 Best Companies to Work For" in America.  It is the third consecutive time the pediatric health care system has been named on the list.  It operates in the metro Atlanta area of Georgia and serves children from all 159 counties in Georgia.

The Triage System: Children's has been working with Clinical Solutions for ten years and uses its telephone triage system in its nurse triage center.  This solution enables them to quickly and safely triage a patient over the phone to determine the appropriate level of care.

Robin Pajot, director of Children's Healthcare of Atlanta, comments, "We have been able to see what's happening from a global perspective.  Using a telephone triage system has enabled us to look outside the usual field of vision and think outside the box; we have new ideas and new ways of doing things."

Children's uses the system in two ways: Firstly, it is used as part of its community center.  A team of experienced nurses and customer resource specialists (CRS) staff the well-known telephone line, 404-250-KIDS, identifying and prioritizing calls, which they pass to the appropriate healthcare professional.  Secondly, Children's uses the system as part of a diverted physician's line, taking calls from 600 physicians across metro Atlanta.  The physician's line is used when the local practices are closed. 

There are 80 people in the call center (with 30 remote users), consisting of full and part-time nurses and CRSs.  Overall, the center takes 285,000 calls per year and triages conditions such as vomiting, diarrhea, congestion, and fever.  Twenty-five percent of the calls each month are from first time callers with new babies.

How the System Works: The system, configured specifically for Children's, combines rules-based and flexible, algorithm-driven models for triage.  Evidence-based questions and answers are used in a logical sequence to assess the patient's condition.  Assessment is made in a safe and consistent framework but allows professional judgment and experience to be used to reach the best possible outcome.

The Statistics: During December 2007:

• 27,150 calls were taken.

• 15,000 were from the doctors' line.

• 7,890 calls were from patients in the community who agreed for the triage encounter call report to be faxed to their primary care physician.

• 2,967 calls were from patients in the community that did not give consent for the triage encounter call report to be faxed to their primary care physician.

• The remainder of the calls were taken on behalf of an insurance company.

The 404-250-KIDS line provided a valuable resource for families in Atlanta, taking over 27,000 calls alone in December 2007.  With this volume of calls, it is imperative that the call center users have the tools they need to respond to the needs of these patients.

The Benefits: Over the past ten years, Children's has benefited from greater efficiency of its resources, supported by an easier workflow and graphical user interface with a similar look and feel to Microsoft Outlook.  The feedback continues to be positive with a significant improvement in patient care and efficiency. 

Pajot continues, "We are always striving to maintain the best possible service to our patients.  By continuously improving the technology we use to process and respond to calls, we are confident that our staff will have the tools they need to provide a high level of patient care."

Children's Future: In the summer of 2008, Children's will upgrade its electronic telephone triage system, enabling a more streamlined process for patients, health professionals, and call center representatives.  It will be the first of its kind in Georgia.  The new system will minimize administration, empowering the center to support a higher number of incoming calls from patients and improve call back times.

The benefits for patients and healthcare professionals include:

• Greater security of information

• Increased efficiency of call handling and resolution

• Improved performance and scalability

• Electronic storage of call logs, meeting the legal requirement

• Reduced environmental impact, of paper storage and associated costs

• Reduced training for center staff

Dr. Joseph Simon, medical director at Children's and a leading authority on telephone triage, explains, "We are proud of our ability to adapt and change system protocols on an as-needed basis, compared to other organizations that are generally limited to yearly revisions at best."

The new solution will significantly improve resource utilization, making the process more efficient for staff and ultimately improving patient care -- the key factor which underlies the concept behind the technology.

For more information about Children's Healthcare of Atlanta, visit www.choa.org; Clinical Solutions' website is www.csdss.com.  Darin Southard is vice president of business development for Clinical Solutions in North America.  He can be contacted at darin.southard@csdss.com or 770-813-2114.