By Gerard Shallo
Hospitals today exist in a challenging time. Not only must costs be managed more tightly than ever, but also the availability of healthcare alternatives requires levels of service previously unseen in the healthcare industry. This applies not only to patients but to caregivers as well, who today have more flexibility to choose the facility at which they work. To add to these demands, hospitals must always keep patient safety in the forefront. This is central to the mission of all hospitals, and ensuring fast, effective communications plays a key role in protecting patients around the clock.
On the front lines of this daily battle is the hospital’s operator group. They not only act as the first level of contact to the outside population and potential customer base, but they also play a key role in carrying out lifesaving communications every day. The importance of the communications going in and out of the contact center demands attention. Leaders in the healthcare community have long known the impact of the contact center on the overall operations of the hospital. This has led to a focus on communications technology to support improvements in patient care and safety, as well as cost reduction. Much of this begins with the contact center, where efficient communications can often mean the difference between life and death.
Given the serious nature of their role, hospitals need to approach communications differently from other industries. Because of this, a different type of communications infrastructure is required. Consider the following:
- Communications can mean life and death: First, communications are mission-critical in a hospital. We are not talking about a message going to voicemail or someone missing a meeting. Lives are on the line.
- Highly mobile workforce: Doctors, nurses, and other healthcare workers are always on the go. They spend the majority of their time delivering care and are not bound to a desk phone or computer.
- Dynamic and complex directory: Patient information is transitory, and doctors may or may not be employed by the hospital, so creating an accurate directory that is continuously updated is a challenge.
- Emphasis on paging and messaging to a variety of endpoints: In healthcare, there is certainly a large emphasis on paging and other types of mobile messaging. This is actually becoming more complex with an ever-widening variety of endpoints that people use to communicate.
- More data from machines: Hospitals have more data coming from machines than most organizations. Examples include nurse call and patient monitoring devices. There is significant potential to redefine workflows within the facility by delivering this data to mobile staff.
- Frequent group communications: Group communications in healthcare are also prevalent. Examples include crash teams and others who need to be notified for quick response to various codes. Notifications may have to go to roles rather than a named individual. An example of this would be the on-call cardiologist.
- Traceable audit trails are essential: Traceability of everything that happened during a particular event is of utmost importance, so a full audit trail is required.
Choose Technology Designed with the Needs of Healthcare in Mind: The advent of computer telephony integration (CTI) has enabled new ways for contact center operators to go about their daily tasks more efficiently, trading in their phones and binders for computers, software, and headsets. There are many operator console products founded on this capability today, offering solid technology at a low price.
While this type of application may work just fine for a standard contact center, the modern healthcare environment dictates intense requirements and far more capabilities due to the life safety nature of everyday tasks. Hospital operators do more than simply answer and transfer calls. They manage code calls for critical patient situations such as heart attacks, infant abductions, and bomb scares. They help patients get in touch with the right doctors by facilitating physician consults. They get important messages to the right person quickly. With every communication, they promote established standards of care, both internally and externally. So what’s the difference between a generic computer-based contact center application and an industry specific healthcare console? Plenty.
Evaluating Options for Operator Consoles: Most telephony-integrated consoles promise fast and efficient call handling, in addition to cost savings, due to the ability to centralize call handling. These systems deliver functionality such as call parking, directory look-ups, and call queue statistics. These powerful features and capabilities go a long way toward reducing costs and creating a more efficient contact center. However, they may lack the functionality needed to truly keep patient safety in the forefront.
As one of the hubs of critical communications for the hospital, the contact center is directly involved in issues of life safety every day. Having this central role requires tools and functionality that go beyond a single system, delivering unified communications capabilities specific to healthcare. This means the ability to connect multiple systems in a way that allows key people to communicate easily using their preferred mobile devices.
Healthcare Communications Requirements: Today’s healthcare contact centers require capabilities that go beyond call handling and into areas related to patient safety, cost reduction, and streamlined communications. Five key functions must be addressed:
1) Integration with ADT/HL7 patient data: Most console applications will integrate with existing telecommunications systems, such as the PBX (private branch exchange), to offer telephony data. But in the hospital setting, who’s calling is just as important as the person they’re trying to reach. When a family member calls for a patient in a hospital, operators should be ready with all relevant and non-sensitive information regarding that patient. This is possible when the console is integrated with a hospital’s ADT (admit, discharge, transfer) data system. When a caller asks for “John Smith,” with a few quick keystrokes the operator should be able to know that John Smith is a patient who was admitted three days ago and doesn’t need to ask the caller to clarify their request.
2) Page-style messaging capabilities to ensure speedy enterprise communications: Paging is an integral channel of communications throughout the hospital. While many of the calls handled by the operator group are page requests, it makes sense for that operator to be able to receive the call, look up the requested physician or staff member, and initiate this message all from the same application. By integrating the console with key messaging systems, the process is simplified and expedited. This is vital when dealing with life safety communications, such as code calls.
Many physicians, nurses, and administrators today must now carry several devices at all times and are looking to trade in their “tool belt” of devices for a single smartphone for everything from code calls and consult requests to personal communications. Smartphones can replace pagers and allow staff to carry a single device for all communications, making both clinicians and IT teams happy. Capabilities, such as text messaging and full two-way communication, improve workflow, while rock-solid reliability ensures critical communications, such as code calls, reach the right person immediately.
3) On-call scheduling tools for operators and individual departments: The goal is to contact the right individual the first time. Therefore, the administration of on-call schedules is a critical responsibility in any hospital and one that can be directly linked to patient safety. Often, this functionality falls on the operator group. Having a correct and widely used on-call calendar is critical to patient safety because it means the right people can be reached on the right device when required. An on-call scheduling platform can be presented to console operators and be browser-based for staff members outside the contact center. It offloads this task from the operator group by giving individual departments a simple system for editing and viewing on-call schedules.
By making on-call scheduling available via Web browser, any user with appropriate access rights has the ability to review his or her personal on-call schedule. For staff members tasked with maintaining the on-call for an entire department, access to all appropriate schedules is readily available for editing as necessary. Many hospitals see the true value of an on-call scheduling tool as expanding the responsibility for schedule maintenance out to individual departments rather than remaining with the operator group. Although this represents a cultural change for many hospitals, having an intuitive tool helps the adoption process. Presenting these schedules in an easily referenced format, such as a standard calendar, makes review and editing simple and quick. It also ensures operators can always reach the right person for urgent and standard communications.
4) Mobile event notification: Many hospitals have inefficient processes for handling critical alarms and events involving point-of-care, security, fire, building management, and other systems. Likewise, critical code communications, which require compliance to standard operating procedures, could often be improved to speed response.
Many hospitals use technology to link alerts and alarms generated by various systems to the operator group and consolidate the management of critical codes and other important notifications. In addition to critical codes, technology can be used to centralize response to alarms for point-of-care systems (such as nurse call, patient monitoring, or ventilators), as well as security, fire, and other operational systems. These notifications can also be sent directly to the appropriate staff members on mobile phones, smartphones, pagers, or in-house communication systems.
5) Reduction of internal “dial zero” calls to operators: Most hospitals report that thirty to fifty percent of the calls handled by the operator group come from internal callers. A significant amount of contact center traffic can be reduced by introducing tools that enable self-service directory lookup, on-call schedule reference and maintenance, and page message initiation.
A Web-based interface to the console directory serves as a data centralization point, a portal through which information can be both input and accessed. Such a tool enables a credentialed user to log in anywhere, at any time, via Web browser to view both his or her own on-call schedule, as well as the schedules of others, perform directory searches, and send pages or messages. Integration with the operator console database expands these capabilities beyond the contact center, allowing operators to focus on offering better customer service and performing revenue-driving activities. These capabilities greatly reduce the number of internal “dial zero” calls that go to the operator group.
Additionally, adding a speech-based directory solution to handle all internal “dial zero” calls will empower the hospital to perform required messaging and call transfers from any phone within the institution. Speech recognition technology may also be deployed externally, allowing the system to front-end main number calls, directing callers to their department of choice.
Conclusion: Technology advances offer new capabilities to hospitals. It is essential to evaluate these opportunities with the mindset that not all options are equal and that what works for other types of environments doesn’t necessarily fit a healthcare environment. When it comes to selecting the solution that will provide the communications foundation for a hospital operator group, due diligence is definitely required. The care and safety of patients – as well as the organization’s reputation – will all benefit from finding the best possible system to fit each institution’s unique needs.
Gerard Shallo, a product manager at Amcom Software, is responsible for the strategy behind a number of unified communications solutions at the company. The key focus for Gerard is to understand the needs of customers and the market as a whole to ensure Amcom continues to deliver mission-critical solutions as quickly and effectively as possible.
[From the August/September 2010 issue of AnswerStat magazine]