Category Archives: Articles

Articles from AnswerStat

Communicating with Seniors

By Barry Spiegelman

Delivering and receiving critical information by telephone is an especially challenging proposition when an elderly caller is on the other end of the line. Whether the impediments are technological, physiological, or psychological, or a combination of all three, telephone communication with seniors requires an elevated level of skill, attention, and patience.

While the younger generation is busy applauding the convenience, mobility, and personalization new telephone technology brings, this same wonderment is often viewed quite differently by seniors. As a rule, older people are less at ease with technology (although it will be interesting to see what happens when the baby boomer generation – who propelled the computer and microchip generation – hits 65). To most seniors, the smaller, faster phones with their buttons and gizmos can present a daunting challenge. Encountering his son’s new voice mail system, a friend’s elderly father said depressingly, “It says ‘press one.’ I don’t have that kind of a phone!”

Keeping up with 21st Century phones, which seem to change daily, is just one of the communication challenges that face older people every day. Not only have the instruments themselves become more complex with added digits, layers of calling “services,” and multiple lines, but the perceived benefits of all of these “improvements” are negligible to many elderly persons whose telephone needs are very simple. While the abilities and deficits of elderly callers vary enormously, seniors can also find the telephone challenging because of physical or sociological factors. These could include:

  • Hearing loss, which may interfere with both speech and comprehension. By age 65, up to half the population may experience some hearing loss.
  • Diminished vision and mobility, which may create obstacles to dialing, following phone prompts, and writing or reading notes.
  • Strokes, accents, or even ill fitting dentures, which may complicate even the simplest verbal communications.
  • Memory loss, dementia, and age-related attention disorders, which may cause a caller to lose the thread of conversation, forget to ask important questions, become frustrated and angry, repeat themselves, or even fall asleep in the course of a call.
  • Loneliness and isolation, which may cause callers to engage in lengthy discussions. For those living alone, the telephone is their essential connection to community.
  • Social or cultural norms, which may lead the caller to avoid discussing problems directly.

Frustrating as they are to the older people themselves, these problems also create daily challenges to unprepared telephone operators or call center agents at the other end of the connection. That makes the capacity to learn and practice effective communication techniques one of the most important skills for all telephone service personnel.

Based on nearly two decades of experience answering more than 15 million calls, many from the elderly, The Beryl Companies has learned the four most essential ingredients to communicating with seniors over the phone:

  1. Anyone who talks to older people on the telephone must remember that patience is an essential tool. Patience means listening carefully, empathetically, not rushing the speaker or jumping to conclusions, and never finishing the caller’s sentences for them. It means reducing distractions and keeping track of what is said during the call. Patience also means not interrupting; the smallest interruption may prevent the caller from completing or returning to their original thought.
  2. Effective communication relies on careful, thoughtful speech. This involves not only taking more time, speaking slowly, and enunciating clearly, but also paying special attention to vocal quality. If an elderly caller is agitated, their voice may rise in pitch and volume. Unconsciously mirroring that tone or being drawn into the caller’s agitation can quickly turn a helpful call into a confrontation.
  3. Eliciting complete and accurate information from an older caller may require special probing skills. Questions may need to be asked, rephrased, and asked again, and the answers paraphrased and reconfirmed. Callers also need to be queried whether they have any lingering questions or concerns before the call is ended.
  4. While respect is an essential component of all telephone service, with older callers, additional measures of respect include using titles such as Dr., Mr., and Mrs., is particularly important. At the same time, be careful to avoid patronizing language or tone. It can be picked up quickly and not appreciated.

Call centers can do their part to aid in the communication process by providing their call center agents with special training specifically focused on speaking with seniors. Through increasing awareness of the nuances inherent in telephone communication with this audience, these agents (at Beryl we call them “call advisors”) can heighten their sensitivities, enhance their skills, and keep their own stress level down. Most important, they can be much better prepared to be of true service the next time the phone rings and an elderly person’s voice is on the other end.

At the same time, older callers can do their part to assure a more productive phone conversation as well. Much of it comes down to simply planning ahead. Here are six suggestions for call center agents to share with their elderly callers:

  1. If possible, make important calls in the morning, when sleepiness is less of a problem
  2. Write down questions before placing the call.
  3. Employ whatever aids are available such as eyeglasses, magnifying devices, hearing aids, and amplified telephone headsets.
  4. Reduce background noise and distractions; a TV or radio may interfere with both hearing and concentration.
  5. Take notes during the call and ask for copies of important instructions by fax or mail.
  6. Finally, if understanding or being understood is a problem, ask for help from a family member or caregiver.

Today’s impressive communication devices provide for instantaneous contact anywhere on the planet, but they don’t assure perfect understanding and don’t guarantee good communication. If an older person has difficulty communicating or following instructions, their lack of compliance is not intentional, nor does it indicate a lack of intelligence. If both parties to the call observe a few measures of planning, patience, and respect, the phone can be the conduit for a productive and satisfying exchange of information. Ultimately, isn’t that what everyone on both ends of the line is seeking?

Barry Spiegelman is co-founder and Chief Customer Officer of The Beryl Companies, which, since 1984, has provided a comprehensive range of outsourced call-center solutions to more than 500 businesses nationwide.

[From the Spring 2004 issue of AnswerStat magazine]

Strategies for Handling Irate Callers

By Nancy Friedman

If your job entails taking calls from unhappy, irate callers, you’ve got your work cut out for you. Many of us are vulnerable to outbursts from callers who are already going through an emotional, stressful time. Handling these calls takes time and training, but it can be accomplished effectively. Here are some service recovery techniques for turning unhappy callers into satisfied ones.

Understand the Source of the Anger: Realize that angry callers are not unhappy with you, just the situation. Don’t take a caller’s hostility personally. You are the lightning rod, not the target. You can do a great deal to diffuse a caller’s anger before you even pick up the phone. How? By smiling before you answer that call. A smile can really be “heard” over the phone. It’s difficult to be rude to someone who’s warm and friendly.

Use the ASAP Technique: Here is my ASAP technique for handling irate callers:

  • Acknowledge the person’s feelings and apologize for the inconvenience the caller has encountered. Make an effort to be sincere. In today’s impersonal society, it’s incredibly rare to hear the words “I’m sorry that happened. Let me get the ball rolling to fix it.” You’ll probably spend about 80 percent of your time massaging the caller’s feelings and 20 percent actually solving the problem.
  • Sympathize and empathize with the caller. Phrases like, “I can understand why you’re upset,” help soothe ruffled feathers. Pretend it is you calling. Then get busy solving the caller’s problem.
  • Accept 100 percent responsibility for the call. This is probably the toughest part. Chances are you had nothing to do with the problem. However, it is your job to accept responsibility and initiate a solution.
  • Prepare to help. Begin by reintroducing yourself. Callers don’t usually remember your name. State that you will be able to help. Use the caller’s name, if possible, which helps diffuse the anger. A willing attitude is essential because if the caller senses insincerity or indifference, he will stay angry. It’s exasperating to file a complaint with someone who obviously doesn’t care.

No Excuses: Never make an excuse to a complaining caller. No one wants to hear, “The computer is down,” or “I’m the only one here.” That is your problem, not the caller’s. When you give an excuse, the caller hears, “I’m not going to help you now.”

Escalating a Call: Sometimes you are not able to solve the problem on the spot. Many times you need more information from another department. Perhaps the call needs to be handled by another person. Although these are legitimate courses of action, they usually upset your caller again.

If you need more information, explain that to your caller. Ask him if he is able to hold while you obtain it, or if he would prefer a call back. Avoid untrue phrases like, “Hold on a sec.” Nothing takes a second. If you need to transfer a caller, let him know the name of the person to whom he or she will be speaking. Give a reason why you are bringing in a third party. “Joe, Mrs. Smith in our claims department is the real expert in resolving your type of problem. Let me transfer you directly to her.”

Swear Stopper Technique: Unfortunately, there are callers who are firmly convinced that abusive language is their only recourse. Try my “swear stopper” technique. Say to the caller in a firm, but pleasant voice, “Excuse me, I can help you with your problem, but I’m not able to handle your abusive language.”

By using this wording, you are taking control of the conversation. Then immediately start asking questions that will help solve the problem. This helps you stay in control of the conversation. Try using these techniques and see how quickly you start handling complaint calls more effectively. Then see how good you feel about yourself; you’ll be doing your job better than ever before!

Nancy Friedman is a keynote speaker at chamber and association conferences as well as corporate gatherings. Call 314-291-1012 for more information.

[From the Winter 2004 issue of AnswerStat magazine]

Vendor Spotlight – Amcom Software

Communication Challenges – Amcom Software Solutions

Amcom Software provides the communication backbone for the hospital.The hospital call center world, while never static, has seen significant technology changes and improvements over recent months and years. A look at trends affecting hospital operations shows that the landscape will continue to shift, and call center management and staff will continue to be challenged to prove and improve their department’s value to their organizations. As one of the leading innovators in the industry, Amcom Software provides ways for hospital call centers to meet the challenges and opportunities these trends present.

The Challenge to Reduce Costs and Increase Efficiency: The need to become more efficient, more effective, and less costly– to help meet the ever-increasing cost pressures faced by all healthcare providers– is a challenge both familiar and well understood. This is made more difficult as call volumes increase and technological sophistication becomes a given within the industry. The opportunity for improvement is made even more complex as patients demand and receive a stronger role in their healthcare decisions, better communication at all points in their care– and at the same time, ask that healthcare costs decline.

The answers to many of these challenges can be found in fully integrated communications systems. These connect patient information, staff scheduling systems, multiple facilities, and communications networks via easy-to-use, flexible, cost-efficient call center operations. Amcom’s integrated suites of call center, emergency management, and critical alert communications solutions are broader, more effective, and completely integrated. Amcom solutions quickly connect with employee and patient records, on-call scheduling, public safety, and other systems to provide accurate, timely communications connections via PBX, VoIP, or wireless networks. Information can flow quickly to the right people, at the right time, via whatever device they choose for a given situation.

The recent addition of Commtech Wireless to Amcom’s portfolio gives customers the ability to connect critical data sources, such as nurse call alarms and patient monitors, to the right people via their preferred communication devices. Commtech also provides industry-leading paging infrastructure and a full line of pagers. They even offer waiting-room “coaster” pagers for the mutual convenience of staff, as well as patients and their families. Moreover, to ensure cost-effective implementations, Amcom’s customer support teams work quickly to achieve rock-solid installations and flawless execution of mission-critical communication strategies.

Expanding Technology: The industry is also experiencing an unprecedented trend toward expanding technology. VoIP, wireless, UC, and mobile Web are all terms virtually unheard in the hospital environment until recently. Add to that the concept of integrating communications technology with critical alert and monitoring equipment and on-call and staff scheduling functions, as well as nurse-call and emergency management systems, and a new concept of the growing importance of hospital communications capabilities emerges.

Many of these technologies, managed by Amcom Software and connectivity solutions, are enabling customers, such as Goshen General Hospital in Goshen, Ind., to achieve dramatic results in the way they respond to life-threatening situations. Goshen has reduced their door to balloon time — the time it takes to get a heart attack patient from ER arrival to surgical-suite catherization — from one hundred twenty-nine minutes to only seventy-one — well below the AHA/ACC goal of ninety minutes. Similar improvements, based on better communications and the planning tools available from Amcom Software, are helping save lives, improve patient outcomes, and reduce costs at hospitals and emergency rooms around the world.

The Growth of Call Center Automation: The healthcare industry is trending toward automation of communication centers because it is the key to strategies focusing on cost savings, productivity, and operator performance. Healthcare institutions also automate to reduce abandoned calls, increase speed of answer, improve operator morale, reduce operator fatigue, and provide Web-based communication. They see automation as a way to consolidate operations, reduce costs, and decrease the number of operator-assisted calls. Recent industry data, for instance, shows that within the next five years, eighty-five percent of health care providers plan to improve their communication centers, with fifty-three percent planning to automate.

Consider the example of Emory University and Emory Healthcare, which first installed computer telephony integration in 2002. Emory’s medical network in Atlanta serves 11,600 students and 2,700 faculty members, as well as the public, through its nationally renowned hospitals and clinics. Emory’s results have been nothing short of exceptional. Amcom call center software allows Emory’s communication staff to more easily and quickly page employees, forward calls, schedule events, and handle growing call volume.

Emory was able to reduce staffing levels in their call center by nearly fifty percent, while creating new positions to provide analysis and planning that have dramatically improved their call-handling results. They have decreased on-call schedule production time and increased their ability to prepare those schedules further into the future. The center can schedule all activities of its individual staff members, from meals and breaks to training, in addition to coverage for other departments.

The call center now produces much more accurate call data. Armed with this knowledge, Emory’s communication center maximizes operator efficiencies during high call times and assigns communication specialists to development and projects during slow times. Despite fewer specialists, the new technology has actually led to a decrease in operator fatigue while improving overall performance.

The Emergency Management Challenge: Hospitals and other healthcare institutions are also realizing the benefits of preparing for emergencies in their own environments. From fires and other threats, to health emergencies among the thousands of workers, patients, and guests on site each day, effective notification that enables safe, orderly handling of emergencies is a significant part of achieving HICS (Hospital Incident Command System) plan goals.

Additionally, quick identification of the source of an emergency call for fast action by emergency responders is also gaining an increased profile within the hospital environment. Improved handling of life-threatening situations is made possible by Amcom Software’s notification, E911, and emergency management solutions. One New York hospital– a large provider in the Yale University Health network– implemented Amcom’s E911 and e.Notify solutions after EMTs had a difficult time locating a person who had dialed 911 from a hospital room. That person survived, despite the difficulty in finding him, but the hospital quickly recognized the issue created by the use of a PBX system that couldn’t provide the exact location of an emergency call.

The Profit Center Trend: As communications teams find they are able to handle additional call traffic, they are moving toward actually becoming a for-profit service working for the benefit of other healthcare organizations. Increasing numbers of hospital call centers now leverage their operator team and technology, as well as their unique expertise in the healthcare field, to provide knowledgeable answering and messaging services to doctor’s offices, clinics, and other healthcare providers in their area. Thanks to the flexibility of their Amcom software, they can answer calls as their clients wish, including customized greetings and forwarding or messaging instructions.

Like the many customers already enjoying the benefits of Amcom Software’s solutions, medical organizations can depend on Amcom’s speed, accuracy, and productivity to manage mission-critical, day-to-day, emergency, and event-driven communications. Amcom Software’s advanced solutions for call center communications, emergency management, wireless messaging middleware, and paging infrastructure are used by thousands of leading healthcare organizations. Amcom’s acquisitions of Commtech Wireless and SDC Solutions, along with the additions of Xtend Communications and Telident E911 Solutions, further solidify the company’s market leadership.

For more information, call 800-852-8935 or go to

[From the Winter 2004 issue of AnswerStat magazine]

The Smaller Side of Outsourcing

By Greg Levin

More call centers are turning to outsourcers to “fill in the gaps” by taking on smaller projects. It used to be that the term “outsourcing” elicited fear in the hearts and minds of many in-house call center managers. Managers generally equated outsourcing with an inevitable loss of control and perhaps even employment. But times, and trends, are changing.

Progressive call center professionals are learning that outsourcing customer care doesn’t require an all-or-nothing proposition involving the elimination of their in-house operations. Those who have taken the time to explore the “smaller side” of outsourcing have found that a good service bureau (and today they do exist) can provide valuable extension services that greatly enhance an existing call center, helping it stay ahead of the competition.

It’s no surprise that partial outsourcing is on the upswing. Rapidly growing call volumes as well as an increased customer demand for round-the-clock service and support through a variety of contact channels are placing a lot of pressure on call centers today. Many of these centers, while well run, lack the necessary capital, human resources, or technology to effectively handle the expanding and changing workload. As a result, they are turning to reputable service bureaus that specialize in filling the gaps. In essence, these service bureaus do the “little” things that can help in-house call centers achieve big results.

Still, some call centers remain skeptical about outsourcing even a small portion of their calls because of the negative reputation that several service bureaus have been tagged with. While it’s true that unreliable and dishonest agencies exist, many are worthy of effectively handling a variety of tasks for call center clients, says Donna Fluss, principal of DMG Consulting and a recognized speaker and writer on customer contact issues. “Even though many of the early [service bureaus] tainted market perception, they are not all bad and some are building viable business models. There are many business situations where it’s beneficial [for a call center] to handle a function outside of its primary organization.”

Opportunities for Outsourcing: Many call centers agree with Fluss. Here are some of the most common ways in which they are using service bureaus to expand their customer contact potential:

  • Overflow support: In an ideal world, the call center’s workforce management specialist nails each call volume forecast on the head and schedules just the right number of agents to cost-effectively handle the load. But the reality is that unexpected call spikes often occur, resulting in long hold times that can damage service levels and customer satisfaction. To cleanly overcome these spikes, a number of corporate call centers contract with a service bureau that can effectively handle the overflow. In such partnerships, whenever the number of calls in queue at the in-house center exceed a set threshold, the overflow is seamlessly routed to agents at the service bureau who have been trained on the client’s specific call types. “Outsourced specialists provide an extra service resource on an ad hoc basis for clients whose own call centers are over-stretched,” explains David Bishop, managing director of Kingston incontact – a U.K. based firm that specializes in managing outsourced customer contact solutions. “A specialist overflow service can ease the burden of excessive peaks on call centers by fulfilling a short-term need for extra capacity.”
  • Peak-season assistance: Not all peaks in call volume are short-term. Many call centers have well defined busy seasons where the average number of calls shoots up for weeks or even months. Rather than recruiting, hiring, and training seasonal staff to help handle the influx, a lot of these call centers turn to a reliable service bureau year-in and year-out. Managers who take this approach often report that it is an efficient and affordable way to provide good service during key busy periods. It also eliminates the need to continually lay-off temporary staff, which often has a demoralizing effect on everybody involved.
  • Specific campaigns and promotions: Some call centers create their own peaks by introducing special product or service campaigns that cause call volumes to skyrocket over short periods. The nature of these calls is usually predictable and basic, often requiring an agent to simply take an order from or send an informational brochure to the customer, which means they can be easily handled by competent service bureau staff. Often during such campaigns and promotions, a special toll-free number is used that connects customers directly to the service bureau, without the need for any special routing from the client’s call center.
  • Routine call handling: Calls generated by specific campaigns and promotions aren’t the only basic contact types that call centers outsource. A number of organizations offload the lion’s share of routine calls that their centers receive daily, thus freeing staff to focus on more complex customer transactions and projects. The consensus among these companies is that their in-house agents are too valuable to spend hours a day handling simple requests. Instead, the companies identify such basic call types via front-end IVR voice prompts in the call center, then automatically reroute them to the service bureau with whom they have partnered. (Note: Most call centers that opt for this outsourcing option keep a small percentage of routine calls in-house to help newer agents develop.)
  • After-hours support: Around-the-clock support is fast becoming the norm in customer contact and patient support, as many callers now expect to be able to reach an agent whenever they choose to do so. Some centers, while wanting to answer this call for 24×7 service, find that it simply isn’t economical to remain in operation all day and night. Consequently, after-hours outsourcing has become a very popular customer care solution. Sometimes call centers choose this option initially to test the waters, then, if they see that off-hour call volumes are high, decide to become a 24×7 operation and bring the outsourced calls in-house.
  • Foreign language capabilities: With the ever-increasing cultural diversity of companies’ customer bases, it’s not uncommon for call centers in the United States to receive calls from callers whose first language is something other than English. However, depending on the labor pool in a call center’s region, it may be difficult to find staff with the language capabilities the center requires. Thus, outsourcing foreign language calls has become inevitable for many call centers. The good news is that plenty of today’s service bureaus have made multilingual services a priority. “It’s possible to provide service in a variety of different languages, 24 hours a day,” says Bishop of Kingston incontact, “with each [agent] individually trained to a specific customer’s requirements.” To do this, many service bureaus have set up shop in or near large urban areas with diverse populations, making it easier to create an agent base that can collectively handle calls in anything from Spanish to Mhong. Some larger outsourcing agencies have separate centers in a variety of different countries, which they can access to expand language services for clients. Sitel, for example, is able to handle calls in 25 languages using this approach.
  • Disaster recovery: One day – or even just one hour – of down time for a call center can be devastating in terms of lost revenue or customer trust. While multisite call center operations are often able to overcome a crisis at one center by rerouting calls to the other centers, single-site call centers do not have that luxury. That’s why more and more companies with only one center are including service bureaus in their contingency planning strategies. Managers at these call centers work closely with the service bureau to develop a solid disaster recovery plan and test it thoroughly. They are then able to sit back and rest assured that their center and their customer loyalty will be protected in the event of system failure.
  • E-sourcing services: Most call centers realize that, to remain competitive today, they need to meet online customer and patient demand for dependable Web-based support. The reality, however, is that many centers struggle to successfully handle email and live chat sessions. Either they can’t find enough agents with the skills needed for these contacts, agents have little experience in managing a Web-based environment, or they lack advanced e-support tools. To overcome their shortcomings, a lot of these call centers have teamed up with one of a growing number “e-sourcing” agencies that specialize in handling organizations’ online contacts. These agencies already have trained Net representatives and the latest technology in place, as well as plenty of experience in providing e-support services for a variety of clients. Many traditional service bureaus have added similar services to their list of outsourcing solutions, which means that call centers looking to e-source can shop around quite a bit for a firm that fits.

Looking beyond the Large: Customer care outsourcing is showing no signs of slowing down. According to Framingham, Massachusetts-based research firm International Data Corp. (IDC), the overall worldwide market for call center outsourcing will grow to $51 billion by 2004. While offshore outsourcing and other mammoth projects involving service bureaus may get most of the call center media coverage, for managers in charge of existing in-house operations it’s typically the “little” outsourcing opportunities that mean a lot.

[This article was originally published by ICMI in Call Center Management Review. It is reprinted with permission from ICMI, 410-267-0700.]

Quick Tips for Outsourcing Success

Just because a call center may choose to outsource a select portion of its calls or contacts doesn’t mean that the partnership can be taken lightly. A company’s careful selection of and constant communication with its service bureau are what determine outsourcing success, regardless of the size and scope of the venture, says Kathy Sisk, president of consulting firm Kathy Sisk Enterprises. Here’s a list of specific practices she recommends to help call centers create and maintain an effective outsourcing relationship:

  • Assign project leaders who can head a team, who have initiative, and who have background experience in the project that is being outsourced.
  • Check to make sure the outsourcing agency you’re considering has low turnover. Ask to see their HR reports.
  • Hand-select the people from the service bureau you want to be assigned to your account.
  • Make sure the outsourcer has a proven background. Don’t just rely on their referrals; speak with a few of their current or past clients. Also interview the management staff who will be assigned to your account.
  • Never give your outsourcer full control. Make sure the outsourcer has a method to allow you to assess the operation onsite or remotely.>
  • Stay on top of the project on a daily basis.
  • Include a “way-out” clause in your agreement that will enable you to easily end the partnership if the agency does not meet your expectations.
  • Don’t focus on the cost to outsource as your number one objective. Consider all the other quality assurance factors such as experience, history, and results that make the cost factors more profitable.

[From the Winter 2004 issue of AnswerStat magazine]

Selecting a PC Attendant Console

By Gary DuPont

If you are a regular reader of AnswerStat magazine, you are probably familiar with the basic concept of a PC-based attendant console. This category typically includes products that either integrate with or replace the traditional telephone operator console and include features such as an organizational directory, patient information paging, and all attendant telephony features.

Over the years, this category of products has witnessed multiple operating system advances and technology improvements. The market leaders in this space can all make claims as to why you should chose their product. MASCO Services Inc. (MSI) selected a PC attendant console solution eleven years ago and over the years has upgraded the platform as required in order to supply our customers with enhanced features and efficiencies. It has also given MSI a competitive edge in its hospital paging and physicians’ answering service businesses. Here are some of the features, benefits and advancements to help guide you and your organization toward selecting the vendor appropriate for you.

Some of the questions you should ask:

  • What CTI (Computer-Telephony Integration) methodologies are used for integrating the telephone system with the PC? Some vendors recommend server based CTI solutions versus client-based.
  • Does a failure of one link (server-based) jeopardize your entire call center?
  • Does the integration support ACD (Automatic Call Distributor) features and true attendant console features?
  • Does the system provide a proprietary telephone system in front of the hospital telephone system and create another link in the communications chain?
  • What is most important to your organization?
  • What is the product life cycle of your current PBX (Private Branch Exchange)?
  • When is your existing Centrex contract up for renewal?
  • Is your telecommunications department considering a move to an IP-based (Internet Protocol) platform?

Features and Functionality: An important way to distinguish one product from another is to review the features offered by each vendor and determine which ones are important to you. Is the software architecture based on industry standards making it open to growth, new technology, and standards? As mentioned earlier, each system available uses an attendant to answer a telephone call, perform a directory lookup, and transfer the call. An important way to distinguish one product from another is to compare each vendor’s features and functionality, then determine which features provide you and your clients the best service in a cost efficient manner.

Return on Investment: A current trend in cost justification is the return on investment model. Vendors have identified this trend and have focused on specific feature to address this, such as:

  • Voice Assisted Transfer: Over time this can reduce call traffic to the operators, since callers will hear the DID or extension number prior to being connected.
  • Recorded Agent Greetings: Operators prerecord answer and progress report phrases, such as “One moment please,” “Still searching.” From a quality assurance perspective, this can be an invaluable tool.
  • Physicians’ Answering Service: This feature allows the same hospital contact center to serve both the hospital’s needs and the needs of the physicians that work there. Often this is provided on a fee basis, but the real cost justification is tying the physicians to the services of the hospital. If you are in this business or plan to be in the future, determine if the vendor has a proven track record in the field. You don’t want to be a beta site for a newly developed or unproven product.
  • Delivery of Messages: This category has been dominated by radio-paging, faxing, email, and voicemail. However, with the advent of in-building wireless systems such as SpectraLink Wireless, Symbol Technologies, and Vocera, the traditional delivery methods are being replaced by devices that can receive a text message. PC-console systems with applications based on these formats will provide even more functionality to the users within the hospital. Features such as this help to provide cost justification by streamlining the communications process and often eliminating the use of an operator.
  • Web-Based Directory, Paging, and On-Call Scheduling: With the advent of the browser interface, more organizations are choosing this feature and giving staff self-service options for directory look-up, paging, administration of on-call schedules, and directory changes. The measurable costs and benefits to this module are recognized by the reduction of the printed directory and calls to the operator. Also, by making the database content public, incorrect entries are noticed sooner, leading to a more accurate database.
  • Speech-Recognition: Speech-Recognition has become the most talked about feature in recent years. This technology is now commercially viable and relatively economical to be used within the healthcare communications world. MSI uses speech-recognition on internal calls to route them to an individual’s office or pager without operator assistance. The reduction in call volume over time to the operator group allows for more time being spent on sensitive calls, providing other non-traditional tasks, and redeployment of FTEs (Full Time Equivalents). Your ACD or PBX reports will also confirm this by comparing before and after historical call data.

There are many other modules and features that can be included within the category of PC-Console. As you do your own research, take the time to compare your finalist to your current needs, your near-term plans, and your long-term strategy. Then compare telephony integration, features, and functionality along with product references. Once this has been completed, your vendor of choice will emerge.

Gary DuPont is Director of Telecommunications and Customer Care at MASCO (Medical Academic and Scientific Community Organization, Inc).

[From the Winter 2004 issue of AnswerStat magazine]

PBX Attendant Consoles

By Peter Lyle DeHaan, Ph.D.

Peter DeHaan, Publisher and Editor of AnswerStat

PBXs (and ACDs) are generally configured with an attendant console. Though a console can take on different forms and appearances, at its most basic, it is a fancy telephone which is given “permissions” to do advanced features that cannot be accomplished by other phones and users on the system.

Traditional Attendant Consoles: Historically, consoles were electro-mechanical devices, with a dizzying array of buttons that took up considerable space on a desk. Over time, these consoles have become less mechanical and more electronic, nevertheless they still function as an expanded telephone.

Many readers, no doubt, still have and use these types of consoles in their hospitals and call centers. Designed for efficient and effective answer-transfer activity, these phones have additional buttons – sometimes a hundred or more – to minimize the number of actions required per call. Additionally, some buttons are “smart keys,” processing multiple actions with a single push (such as “hold” current call and “connect” to new call) or changing function depending on the situation (such as “answer” if not connected to a call, but “hook-flash” if connected).

PC Attendant Consoles: Although these standard, entry-level consoles are vastly superior to the functionality and efficiency of a standard PBX phone set, they pale in comparison to the ease-of-use and feature-rich effectiveness of a PC attendant console. As the name implies, PC attendant consoles are computer-based call-processing units with a familiar Windows interface.

A basic PC attendant console is available from virtually all PBX vendors. There are several benefits provided by PC attendants. First and foremost is that calls can be processed faster, requiring less arm movement and with touch-typing speed. This implies labor savings and cost reduction. If even one FTE (full-time equivalent) is saved per year by using a PC attendant, then it has more than paid for itself. However, the labor-saving effect is often greater than one FTE – and occurs year after year.

A second benefit is the Windows interface. Trainers generally concur that training is easier and faster on a familiar-looking computer screen with intuitive actions, than on a intimidating and foreboding traditional console. In fact, unless advanced functions are repeated frequently on a traditional console, they tend to be forgotten, performed incorrectly, or done without confidence. With the user interface of a PC attendant, these concerns are greatly minimized.

A third benefit is added functionality. Even at its most basic, a PC attendant includes a directory feature, allowing for instantaneous access to hospital extensions and room numbers. This speeds answer-transfer functions and greatly increases accuracy. Therefore, for the one-time cost of purchasing a PC attendant, there are ongoing labor savings, training efficiencies, and additional functionality.

Advanced PC Attendant Consoles: More sophisticated PC attendants are available from third-party providers. These include both software-centric solutions and hardware implementations. Whereas a PC attendant is an adjunct offering from a PBX vendor, it is a core competency and primary focus of third-party providers. Although the details vary, along with their respective labels, here are some features you can expect from a third-party PC attendant:

  • CTI (Computer-Telephony Integration) directly links a call with the information needed for that call or that is gathered from the caller. There are various levels of sophistication with CTI, but most third-party providers have implemented this at its most optimum level. (See Information Transfer and ANI.)
  • Directory Services which are available enterprise-wide, assist agents in quickly and accurately locating members of the organization.
  • Agent Greeting goes by many different names such as Operator Saver, Perfect Answer, Answer-with-a-Smile, and Personalized Auto-Answer. It provides automated greetings in the attendant’s voice. This allows an agent to record a “perfect” greeting and then use it repeatedly throughout the day, guaranteeing that every call is optimally answered. Other benefits are less agent fatigue and a stronger voice at the end of the shift. This is a requirement in hospital and call center environments.
  • Messaging Options enable operators to type messages into their computer and to send them, at the touch of a keystroke or two, to any destination including voice mail, email, fax, printer, pager, or text-enabled cell phone. Third-party PC attendant providers put great emphasis on the messaging aspects of their systems, providing a powerful array of message processing features and options. This also provides the platform on which to offer telephone answering service.
  • ANI (Automatic Number Identification) displays the caller’s number (when it is available) and copies it into the call record or message form. This streamlines message taking and reduces errors.
  • On-Call Scheduling enables agents to reach the right people no matter how often their schedules and availability may change.
  • Call Recording lets agents selectively record a phone conversation.
  • Call Logging (Voice Logging) digitally records all calls, of all agents, 24 x 7. Recordings are available as needed for training, verification, and problem resolution. (Without corroboration, the agent is always blamed for errors and quality concerns, but amazingly when a recording of the call can be accessed, the agent is vindicated over 90 percent of the time.)
  • Information Transfer allows information and data that an operator enters into the computer to be retained with and accompany the call if it needs to be transferred to another agent or supervisor for call completion or resolution. This keeps callers from needing to restate pertinent information, such as their name, PIN, account, address, call-back number, and so forth.
  • Administrative Monitoring and Reporting provides real-time monitoring of call center activity and reporting procedures, including call statistics and messaging activity.
  • Database Functions helps administrators maintain internal, up-to-date information that is available to all agents, as well as accessing external databases, which can be displayed on the agents’ computer station. Databases can be either read-only or allow updating and data-entry capabilities.
  • Speech Recognition streamlines various functions and can automate repetitive tasks.
  • Text-To-Speech allows callers to automatically listen to database information without an operator needing to read it. One prime example is an employee or client automatically retrieving messages without operator involvement.

Healthcare Applications that have been designed and implemented specifically for a medical or hospital environment include

  • On-Call Calendars
  • Patient Directory
  • Physician’s Referral
  • Physician Registry/Locator
  • Physician’s Consult
  • Class Registration>
  • Wake-Up Calls

This is a summary of the key features available today. Other items are also available and the list is growing as vendors make their products more robust, powerful, and feature-laden.

Integrating Third-Party PC Attendant Consoles: PBX vendors may be apprehensive about third-party PC attendants. Obviously, most sales staff would rather sell something they will make a commission on, as opposed to recommend another company’s product. From a pragmatic standpoint, however, concerns do exist about working with another vendor to make a solution function as expected and the inevitable finger pointing that occurs should something not work.

As such, third-party vendors go to great lengths to minimize this concern and to ensure that the installation and interface goes as planned and works as represented. Even so, many purchasers insert a clause into the contract or purchase order to address this very issue. Vendors who are confident in their product and their capabilities are open to accept any reasonably worded clause relating to equipment interfaces and inoperability.

See our listing of PC console software providers.

Peter DeHaan is the publisher and editor-in-chief of AnswerStat magazine and a passionate wordsmith. Connect with him on his personal blogs, social media sites, and newsletter, all accessible from

[From the Winter 2004 issue of AnswerStat magazine]

How to Evaluate a Protocol

By Sheila Wheeler, RN, MS

Whether you are evaluating electronic or paper based protocols the same basic steps should be followed. Begin the process by obtaining paper copies of the following items: the table of contents, three representative protocols (abdominal pain; nausea and vomiting; or respiratory problems), and the documentation form.

Ask the vendor:

  • How Were They Developed And Tested? Were the protocols developed by a single RN, MD, or a Nurse Taskforce? When it comes to protocol development, four heads are better than one. A taskforce working collaboratively as a group is superior to the single developer working alone or taskforce members working independently.
  • Who is best suited to develop protocols, RNs or MDs? Nurses are best suited and more economical as protocol developers, while physicians are best suited to consult, review, and approve them.
  • What were the qualifications and experience of the taskforce members? The best candidates for protocol developers are expert level nurses or nurse practitioners with expertise in pediatric and adolescent medicine, adult, geriatric, and OB/GYN medicine as well as experience in telephone triage. Physicians who are familiar with and supportive of nurse telephone triage are the best consultants and reviewers.
  • What is the optimum development time? For a complete set of protocols (50 to 100) a development time of less than six months is suspiciously fast. Usually, one to two years is more realistic.
  • How long have the protocols been in use and where? A history of several years or more in large, busy group practice or HMO is more meaningful than a few months in a small office.
  • How Are They Designed To Be Used? There are two distinct philosophical approaches to protocols and decision-making in telephone triage. One philosophy is that the nurse’s judgment is primary and that protocols are a decision support tool. A competing philosophy is that the protocols do not require trained professionals and thus are the ultimate decision making tool. Decision support has been defined as an expert system designed to remind experienced decision makers of alternative options or issues to consider. Decision-making systems are defined as expert systems that allow non-experts to make decisions beyond their training and experience. Ask whether the protocols require an autonomous professional or whether the phone interaction is mainly “protocol driven.”

Assess the protocols:

  • Table of Contents/Title System: One quick and easy way to assess a set of protocols is to simply review the table of contents which is essentially the author’s “search engine” to find the right “tool” in the system. Remain alert to titles that are confusing, inconsistent, or redundant. For example, is lay language mixed with medical terminology? Is there a consistent, intuitive approach to titling? Are the protocols listed consistently by system, site, or symptoms, or are they a confusing mix of all three? Poorly organized titling results in a search engine that is not user friendly and slows the interaction.
  • What is the scope of the collection? Having too many or too few protocols decreases the “user friendliness” of the product. Too many protocols results in excessive page turning or screen changes, which can be confusing and time consuming. Too few protocols leads to the “out of protocol experience,” where the nurse is left without adequate protocol coverage and must “fly blind.” The optimum number of protocols is between 50 and 100, which covers about 1000 common diagnoses, including common emergencies.
  • Documentation Form: The protocols should have an accompanying documentation form. It should contain the steps of the nursing process – assessment, impression, treatment, and self-evaluation. In addition to demographic information, there should be ample space for the assessment and treatment sections. Labeled spaces for standard information to be collected, trigger words for key questions, well-developed problem/client history section, and words delineating the nursing process will facilitate complete, accurate data collection. Forms that have too much blank space or are too busy are not user-friendly.
  • Test Driving and Training: Once you have narrowed the selection down to two or three designs, have staff test them out, using scenarios. See how effective they are to use within the “real world” time of 10 minutes per call. Finally, for best results, all protocols (paper-based included) require training in their correct and safe use. Training affords the staff the opportunity to fully grasp the design, achieve buy-in, shorten the learning curve, and facilitate compliance.

Sheila Wheeler, RN, MS, is an expert in the field of telephone triage. Ms. Wheeler is the author of Telephone Triage: Theory, Practice, and Protocol Development (Delmar Publishers: 1993) and Telephone Triage Protocols for Pediatric and Adult Populations (Aspen Publishers: 1998). She is the founder and chairperson of the annual telephone triage conference, “Telephone Triage: Essentials for Expert Practice.”

[From the Winter 2004 issue of AnswerStat magazine]

Medical Call Center Glossary

This glossary was written, complied, and edited by Peter L DeHaan, PhD. If you have a word you would like defined and see added, send an email to

Abandoned Calls: in outbound calling, a call that is made by a predictive dialer but is subsequently disconnected if no agent is available. In inbound teleservices, a call where the caller hangs up before an agent answers.

AC (Alternating Current): Standard household current, available at wall plugs and used to power most electrical devices. The most common AC Voltage is 120, although 220/240 and 440 also exist. AC is the opposite of DC (Direct Current).

ACD (Automatic Call Distributor): An ACD is commonly used to route and deliver incoming calls in call centers to agents. Compare to a PBX and switch.

Agent: A generic name for call center employees, encompassing both CSRs (Customer Service Representative for inbound calls) and TSRs (Telephone Sales Representative for outbound work).

Analog: A signal or voltage that can vary continuously between two values. Contrast to digital which can possess only two states or conditions. Speech is analog, but with modern technology, it is often converted into a digital signal to be transmitted and switched.

ANI (Automatic Number Identification): A telephone company service that provides the telephone number of the calling party (and sometimes their name) electronically to the called party while the phone is ringing. It is a more sophisticated version of caller ID.

Answering Service: See Telephone Answering Service and Telemessaging.

Area Code Overlay: When a new area code is assigned to the same geographic region as the existing area code(s), which is in jeopardy of depletion. With an overlay, no one needs to change area codes. However, if it is not already implemented, ten-digit dialing becomes required for all calls, even local numbers. All new number assignments are in the new area code. As such, ordering a second line could result in a number with a different area code. Overlays are not popular with most consumers, as they do not want to dial ten digits on every call, nor remember different area codes for friends and neighbors. Contrast to an area code split.

Area Code Split: When the geographic region of the area code is divided in two. One part will keep the same area code, while the other section must switch to a new area code, but they will retain their seven-digit number. There is a transition period for this, called permissive dialing, in which either the old or new area code can be dialed for the affected section. After a time, mandatory dialing goes into effect, when any call to the new region using the old area code will not go through. These numbers eventually become available for reuse. Splits are not popular with most businesses because  it requires printing new stationary and other changes, as well as reprogramming phone systems. To avoid repeating this process in a few years, sometimes a three-way split is made at the same time. Contrast to an area code overlay.

ASP: An acronym for Application Service Provider, it refers to a company that makes software available via the Internet. The ASP handles maintenance, upgrades, and backups. End users pay a fee to use the software.

Auto Attendant: see IVR.

Automated Dialer: a program or device that will dial phone numbers for agents (compare to Predictive Dialer).

B Channel: In ISDN service, the B channel is also called the bearer channel and is used for voice transmission. In BRI-ISDN, there are two B channels, whereas in PRI-ISDN, there are 23 B channels; all B channels use 64 kbps of bandwidth.

BA: See Business Associate.

Benchmarking: a statistical standard by which a call center can measure relative performance.

Blended Agent: a call center agent trained and capable of handling both inbound and outbound calls.

Blended Center: a call center that handles both inbound and outbound work.

BPO (Business Process Outsourcer): a company that provides various business services to other companies, including call center services (see Teleservice Provider).

BRI-ISDN (Basic-Rate Interface ISDN): The simple version of ISDN that allows for two main channels for voice, fax, or data and one data channel (primarily for control purposes). See ISDN; compare to PRI-ISDN.

Bridge Clip: a small conductive metal device used to electrically connect a phone line from one point to another. Generally, the bridge clip is used on a “split block” and is often the “demark point” between the phone company and call center. Removing the bridge clip allows the telephone company and customer equipment to be disconnected from each other and isolated for troubleshooting.

Bureau: Another name for a teleservice company or outsourcing call center.

Business Associate (BA): Under HIPAA, a person or organization that performs a function or activity on behalf of a covered entity (CE).

Call Back: A website feature that allows a user to submit a request for an agent to call them. Compare to the “talk-to-me” feature, which uses VoIP to establish a phone connection over the Internet.

Call Center: Any centralized location to which calls can be directed, answered, and processed. However, in common usage it also encompasses operations that may be decentralized and that process more than calls. Contact center is a broader term that is often substituted for call center

Call Forward-Busy Line: a variation of call forwarding where a call will be forwarded only when the line is busy. This is a great way to get overflow calls to the call center. It is often used in conjunction with call forward-don’t answer.

Call Forward-Don’t Answer: a variation of call forwarding where a call will be forwarded only when the line is not answered after a certain number of rings. In actuality, this is done by timing, with six seconds equaling one ring. Therefore, if it is ordered for three rings, it will forward after eighteen seconds, regardless of where it is in the ring cycle. Call forward-don’t answer is a great way to send overflow calls to a call center when the client doesn’t or can’t answer them. Also, call forward-don’t answer is often used in conjunction with call forward-busy line or as a backup to regular call forwarding in case the client forgets to activate it. Call forward-don’t answer can be overridden by regular call forwarding.

Call Forwarding: a service provided by the telephone company that allows calls received at one number to be automatically redirected to another number, whether local or long distance. In either case, the line with the call forwarding is charged for the cost (if any) of rerouting the calls to the other number. When a phone is call-forwarded, it usually rings at the main location to indicate that it is being forwarded, but it cannot be answered. When call forwarding has been activated, calls can still be placed from that phone.

Caller ID: the caller’s phone number and possibly name (compare to ANI).

CAP (Competitve Access Provider): See CLEC (Competitve Local Exchange Carrier).

Card: a portion of a computer or switch containing circuits and components which can be easily removed and replaced; also more commonly called a circuit card or circuit card board.

CD-ROM (Compact Disk – Read Only Memory): A high capacity medium to store computer programs, data, and even music and video in digital format. In common usage, it is shortened to CD. Compare to DVD.

CE: See Covered Entity.

Central Office (CO): A telephone company facility where customers’ lines are connected to switching equipment so that they can call other numbers, both locally and long distance.

Channel: relative to sales, a channel is the means by which agents interact with consumers, including telephone, website, email, Web chat, fax, and mail.

Churn Rate: can relate to call center clients or agents. In reference to clients, churn is the percentage of clients that cancel service within a period of time, typically measured per month or per year. In regards to agents, the churn – or turnover – rate is the percentage of agents who leave during the year (contrast with Retention Rate).

CLEC (Competitive Local Exchanged Carrier): A relatively new telephone company, competing with the entrenched local telephone company (called ILECs) who used to be a protected monopoly. CLECs are believed to meet customer needs and drive innovation much better than the traditional telephone company. CLECs serve to push down prices for local telephone service. They are also called CAPs (Competitive Access Providers); compare to LEC and ILEC.

Client: A customer of an outsource call center or telephone answering service.

Co-browsing / Web-collaboration: technology that enables an agent to assist someone using a website, whereby the agent can temporarily manipulate the person’s Web browser to display requested information or navigate to a specific page.

Coaching: the process by which a trainer or supervisor provides feedback and support to call center agents so that they may improve their skills and effectiveness.

Conference: A procedure where three or more people are connected together on a telephone call and can talk simultaneously to one another.

Confirmation: occurs at the completion of a sales call when the agent confirms the item or service purchased, payment information, and key customer details such as address. Often the confirmation is recorded or made by another individual (compare to Third-Party Verification).

Contact Center: A newer name for a call center, reflecting that other forms of contact (email, fax, text chat, Internet call back, VoIP, and even regular mail) are handled in addition to phone calls.

Covered Entity (CE): Under HIPAA, in simplistic terms, an entity who transmits health information. The exception would be a Business Associate, who performs such a function on behalf of a Covered Entity.

CPR: An acronym for Computerized Patient Record. See Electronic Medical Record.

CRM (Customer Relationship Management): the means (including strategies, processes, people, technologies) by which companies maximize customer interactions. Call centers are often in the forefront of CRM initiatives.

CSR (Customer Service Representative): An employee of a call center tasked with providing phone support to customers who call for assistance. See agent and contrast to TSR.

CSU/DSU: stands for Channel Services Unit/Digital Services Unit; a device that is the demark point and interface used between call center equipment and a digital circuit, typically a T-1 or ISDN line. It offers protection and serves as a diagnostic point.

CTI (Computer-Telephony Integration): Integrating a computer system with a telephone switch to allow relevant computer database information about the caller or account to be presented to the CSR simultaneously with the call. The telemessaging industry enjoyed basic CTI functions with its first computerized systems in the mid 1980s, years before it was introduced to the general business market. Now, more sophisticated second-generation CTI platforms are common, representing the leading edge of technology.

D Channel: In ISDN service, the D channel is also called the delta channel and is used for control and signaling functions. In BRI-ISDN, the D-channel is 16 kHz of bandwidth; in PRI-ISDN, the D-channel is 64 KHz of bandwidth.

DC (Direct Current): A steady flow of electricity in one direction; it is the opposite of alternating current (AC). Power supplies in equipment often run on AC, but convert it to DC. Telephony switches, especially Central Offices, make extensive use of 48 Volts DC. The 48 Volts DC is what provides the “talk battery” on a telephone.

Decision Tree Software: A computer software program that presents a series of predetermined questions, each based on the answer of the previous question, allowing the user, or agent, to reach a correct decision even though they do not personally have the expertise required to make such a decision. See help desk.

Dedicated 800 Service: The opposite of switched 800 service whereby the 800 numbers are permanently connected to the customer’s switch, usually via T-1.

Demark Point: a point of demarcation (“demark”) between the telephone company and the call center equipment, allowing the telephone company’s circuits and the call center’s equipment to be disconnected from each other and isolated for troubleshooting and testing. For lines and trunks, the demark is generally a bridge clip on a split block. More sophisticated telephone services, such as ISDN, DSL, and T-1, also have a demark point, typically a CSU/DSU.

DID (Direct-Inward-Dial): A special telephone service in which there is no direct relationship between one line and a specific telephone number, but where many different numbers can be served by the same trunk or group of trunks. To specify which number was called, identifying digits are dialed on the trunk and decoded by the equipment. By definition, calls can only be received with this type of service, however, many phone companies have enhanced DID service so that calls can be made on DID trunks as well. This allows for greater efficiency (since they can be used for two purposes) and also a higher quality patch (since it is switched and handled by the phone company’s central office). This is called two-way DID, but it is not available from all phone companies or from all central offices.

DID Numbers: A group of usually consecutive numbers, often in multiples of 20 or 100 that are used for DID service. The numbers have no unique physical line and calls cannot be placed on a DID number.

DID Trunks: The physical lines that DID calls are received on. Many DID numbers can be handled on a few DID trunks. Although phone companies and telephony engineers often recommend ratios as low as one trunk for each six numbers, the common reality for the telemessaging industry is a much higher ratio, such as 1:25.

Digital: The representation of information in a two state format, either “on” or “off,” 1 or 0. Computer programs, information, and instructions all exist in digital form. Speech, although an analog waveform, is often converted into a digital format for transmission or storage (such as in a voice mail system). The electrical transmission and switching of speech in digital form provides greater overall quality and less noise than doing so in analog form. Most modern switches are digital switches and represent improved quality over older analog switches.

Digital Switch: The device that directs or routes calls. As the name implies, all phone calls are processed as digital signals. A digital switch is more advanced and produces higher quality connections that are less prone to noise. Virtually all switches currently on the market today are digital switches.

DIP Switch: an acronym for Dual In-line Package, a series of miniature switches, all housed in one component, commonly used in computer and telephony systems to set options (compare to Jumper).

DNC (Do Not Call): lists of numbers that should not be called. From a legal standpoint, there are federal and various state lists of consumers who should not be called. Calling a number on one of these lists can result in fines, penalties, and sanctions. Additionally, businesses and call centers often keep their own lists of consumers who can legally be called but have requested otherwise. (There are comparable efforts for “Do Not Mail” and “Do Not Email”; unsolicited faxing is illegal.)

DS-1: See T-1.

DS-3: See T-3.

DSL (Digital Subscriber Line): A transmission protocol that allows data to be sent over standard copper wires at high speeds. There are several different types of DSL service, such as ADSL and VDSL, each providing different transmission speeds. DSL is often used for Internet access.

DTMF (Dual-Tone, Multi-Frequency): Also known by the AT&T registered trademark of Touch-toneâ. It is a method of placing a call whereby a unique pair of tones are used to represent each digit of the phone number.

DVD (Digital Video Disk):  A high capacity data storage medium, designed to store multi-media programs and adopted for computer program and data storage. Compare to CD-ROM.

E&M: a telephone signaling protocol that uses separate wires for signaling and voice. There are several variations of E&M signaling. A common use of E&M signaling is to connect voicemail and two-way systems to other switches and devices.

E-1: a European counterpart to T-1, it is a designation for a high-speed, four-wire data circuit that can accommodate up to thirty-two separate audio channels.

Electronic Medical Record:  Having a patient’s medical record in electronic form versus a paper file. The trend is to move towards electronic health records. This a huge benefit for medical call centers and the medical community as a whole.

EHR: An acronym for Electronic Health Record and another name for  Electronic Medical Record.

Email: A text form of communication, analogous to voice mail. Anything that can be stored on a computer can be sent from one email address to another. Email that has access to the Internet can send a message to any other Internet email address anywhere in the world. Generally, email messages are short, informal typed messages. However, they can also be long or formal and can contain attached files and pictures.

EMR: An acronym for Electronic Medical Record.

EPROM: Erasable Programmable Read Only Memory (see Firmware).

Ergonomics: the art and science of making a workplace, such as a call center, comfortable to work in by minimizing physical strain or stress.

Fax Server: An external device that accepts client messages from a telemessaging platform, converts them into the format used by fax machines, and delivers them to the client’s fax machine. Many fax delivery units have been expanded to send alphanumeric pages and email messages as well.

Flat Rate Service: A phone company designation indicating that an unlimited number of local and/or long distance calls are included in the monthly service fee. Compare to measured rate service.

Firmware: a combination of software and hardware; specifically, software that is contained on a chip (hardware). Generally, firmware is a PROM or EPROM.

Fulfillment Services: processing mail, packaging products, or performing other services for a marketer. Fulfillment services may also include call center, database, list, or other marketing support services.

Generator: A device to produce electricity to run equipment in the event that commercial power is lost. Generators are powered by gasoline, propane, or natural gas and produce the AC power required to run electrical equipment. Generators are sometimes used in conjunction with or as an adjunct to UPS (Uninterruptible Power Supplies).

Gigabyte: A measurement of computer memory capacity, a gigabyte is one billion bytes of data or 1,000 megabytes. Sometimes incorrectly shortened to “gig” or “gigs.”

Gigahertz: A measurement of transmission frequency, either over the airwaves or through a conduit such as a fiber optic or network cable. One gigahertz is one billion times a second or 1,000 megahertz.

Ground Start Lines: An alternative type of business line that requires the circuit to be electrically grounded before answering or placing a call. It is not common, but is considered superior to its ubiquitous cousin, the loop start line.

Handsets: a standard telephone receiver used to communicate via telephone. To increase efficiency and be ergonomically friendly, call centers universally use headsets instead.

Headset: A hands-free device allowing one to talk on the phone and yet keep both hands available for typing. Headsets are highly recommended for call center agents.

Headset Box: A network interface box into which a headset amplifier is plugged. A headset box is connected to the phone system (be it a PBX, ACD, or switch). Some equipment allows a headset to be directly connected without the need for a headset box.

Help Desk: A segment of the call center industry, whereby entry-level staff can use decision tree software to answer questions and provide basic support functions for technical applications.

HICS: An acronym that stands for Hospital Incident Command System. It is a comprehensive incident management system that tracks and addresses emergent and non-emergent situations across hospitals.

HIPAA: An acronym for the Health Insurance Portability and Accountability Act of 1996, which among other things addresses the privacy of health information and has wide-ranging ramifications to the medical community in general and medical call centers specifically.

HIS: An acronym for Hospital Information System.

HL7: An acronym for Health Level 7, it is a standard for healthcare and is the interface standard for communication between various systems employed in the medical community.

Home-Based Agent: a call center agent working out of his or her home. Home-based agents are connected to the call center through the Internet or a telephony connection (see Remote Agent).

Hosted Solutions: see ASP

ILEC (Incumbent Local Exchange Carrier): One of the original local phone companies that resulted when the Bell System was broken up in 1984. See LEC; compare to CLEC.

IM: See Instant Messaging.

Inbound Telemarketing: One of two aspects of telemarketing where customers or prospects call a company for assistance when they want or need it as opposed to outbound telemarketing where the company calls customers or prospects.

Instant Messaging (IM): Commercial versions of text chat that allows Internet users to type messages to one another. There are several competing instant messaging services, which have varying degrees of compatibility with each other.

InterLATA: Literally, between LATAs. InterLATA traffic is generally the domain of the long distance carriers (IXCs).

Internet: A complex international network of networks, allowing email and information to be readily sent from one computer to another. Several different services are available on the Internet, including email and the World Wide Web.

Internet Service Provider (ISP): a company that provides access to the Internet, along with other related services.

Internet Telephony: See VoIP (Voice Over Internet Protocol).

IntraLATA: Literally, inside the LATA. IntraLATA traffic is generally the domain of the local telephone companies (known as generally as LECs or specifically as ILECs and CLECs). See LATA and contrast to InterLATA.

IP Telephony (Internet Protocol Telephony): See VoIP (Voice Over Internet Protocol).

ISDN (Integrated Services Digital Network): An international standard for all digital telephony communication. There are two types of ISDN: BRI-ISDN and PRI-ISDN.

IVR (Interactive Voice Response): A computerized system that allows callers to interact with and receive information from a database using touch-tone signals. The information is provided audibly using text-to-speech conversion. Some IVR systems will also recognize basic speech instead of requiring callers to press keys on their telephone.

IXC (Inter eXchange Carrier): A telephone company that does not provide local telephone service, but which does provide long distance service.

Jumper: a device used on printed circuit cards to provide basic operating settings for the card. Generally a jumper is a small metal connector, covered with plastic and designed to slide over two pins on the printed circuit card (compare to DIP Switch, which is used for the same purpose).

LAN (Local Area Network): a local network of computers.

Last Mile: A term referring to the final leg in connecting a home or business to the public switched telephone network (PSTN). Traditionally this was and often still is done via a pair of copper wires, though it can also be coaxial cable, fiber optics, or even wireless transmission. Although new technologies are implemented in central offices and in distribution networks, it is the last mile that is the last to be upgraded. See local loop.

LATA (Local Access and Transport Area): In most cases the LATA was essentially the area code. However, with area code splits and overlays this simplification is losing clarity. A LATA is the geographic area in which the local phone companies can generally handle calls without assistance from long distance companies (IXCs). A LATA serves as a legal limitation as opposed to a technical constraint.

LDAP: An acronym for Lightweight Directory Access Protocol, which defines a standard for organizing directory hierarchies and interfacing to directory servers.

Lead Generation: gathering information from a prospect or customer in order to prequalify them for potential future follow-up. The follow-up can occur face-to-face, over the phone, via email, using direct mail, or by fax.

LEC (Local Exchange Carrier): The local phone company. LECs used to be a protected monopoly (and some still are). See CLEC (Competitve Local Exchange Carrier) and ILEC (Incumbent Local Exchange Carrier) for two types of LECs.

List Brokers: companies that accumulate and provide contact lists for sale and/or rental to marketing companies, businesses, and call centers.

List Conversion Rate: the ratio of successful calls (such as a sale made or an appointment set) to the number of calls made from list.

List Managers: companies that compile, update, and manage consumer or business information, including names, addresses, phone numbers, email addresses, and other data that may be useful to a marketing company, business, or call center.

List Seeding: a method of verifying delivery and/or detecting unauthorized usage by adding false names to the mailing or calling list.

Live: A somewhat inane term to indicate that a call will be processed by a real person as opposed to automation from an IVR platform, voice mail system, or an answering machine. Although call automation is preferred in some circumstances, most consumers prefer to interact with a person, presuming that that person is trained and empowered to assist them.

Live Chat: real-time communications using Internet “chat” technology, also called text chat and similar in concept to IM (Instant Messaging).

Local Loop: The connection between the local phone company and a business or residence. This is comparable to, but more encompassing then, the last mile.

Long-Distance Reseller: a company that purchases long-distance service in bulk at a reduced price to resell at a rate below what a long-distance company would normally charge an end user.

Loop Start Lines: A standard business line, in which a circuit needs to be closed in order to get dial tone or answer a call. Most individual phone lines are loop start. Compare to the less common ground start line.

Measured Rate Service: A phone company designation indicating that each local call is counted (measured) and billed to the calling party. Businesses in many areas are on a measured rate, though some enjoy a flat rate service where an unlimited number of calls can be placed without incurring an additional charge.

Megabyte: A measurement of computer memory capacity, it is one million bytes of data. It is often incorrectly shortened to “meg” or “megs.”

Megahertz (MHz): A measurement of transmission frequency, either over the airwaves or through a copper wire; also, a measurement of the clock speed on a computer. One megahertz is one million times a second.

Modem: Modems are used to send digital information, in analog form, over regular (analog) phone lines. Technically, a modem is an electronic device that MOdulates data into an analog signal and DEModulates it back to digital. Common applications for modems are alpha paging and dialing into the Internet.

Monitoring: a quality assurance (QA) function used by call centers to assess quality, coach agents, and verify call compliance.

Nearshore Call Center: an offshore call center located near the client’s country and therefore more easily accessible.

Nurse Triage: See Telephone Triage.

ODBC: An acronym for Open Database Connectivity and is a database standard. Any database that is ODBC compliant can connect to any other database that is ODBC compliant.

Offshore Call Center: a call center located in another country than the client.

On-Hold Service: music or messages that is provided for callers who are on hold, waiting for “the next available agent.” The recordings can be purchased from on-hold service providers, most of who will ensure that the music is royalty free and legal to use.

Operator: A generic, but obsolete, term for someone employed by a telemessaging company to answer calls, take messages, and distribute those messages. Often a more descriptive and positive term is used to avoid old-fashioned stereotypes. The label of Customer Service Representative (CSR) or agent is preferred. In other contexts, an operator can refer to a telephone company employee.

OPX: Off-Premise Extension; a service that functions identically to a residential extension, but with the extension at a different location. Once a primary method of connecting clients to telemessaging services, phone companies now charge a substantial fee for OPX; therefore, call forwarding is generally the connection method of choice.

Outbound Telemarketing: One of two aspects of telemarketing whereby a company proactively calls consumers or businesses in order to make sales. Contrast to inbound telemarketing.

Outsource Call Center: A call center that provides various call answering and call processing services to third parties for a fee. Sometimes called Teleservice Companies or a Service Bureau. This term is sometimes also used to encompass telephone answering services or telemessaging services. See Outsourcer.

Outsourcer: A call center that processes calls for other companies.

Outsourcing: The concept of taking internal company functions and paying an outside firm to handle them. Outsourcing is done to save money, improve quality, or free company resources for other activities. Outsourcing was first done in the data-processing industry and has spread to areas, including telemessaging and call centers. Outsourcing is the wave of the future.

Patch Cord: A short cable often used in a patch panel, to easily and quickly connect two points together.

Patch Panel: A junction or interface where telephone lines or computer network cables can be easily and quickly connected or moved using short patch cords. A patch panel saves time and costs when installing or reconfiguring telephone or computer access.

PBX: A phone system that has many of the same capabilities as a phone company’s central office. A PBX is sometimes referred to as a switch. Most larger businesses have a PBX. Contrast to an ACD found in most call centers.

PHI: An acronym for Personal Health Information.

PIC (Primary InterLATA Carrier): A designation for a main, or default, long distance company. Although it is an oxymoron, some areas allow an IntraLATA PIC to select a long distance carrier for calls made within the LATA.

Port: A generic name for the portion of a card that connects with a line, trunk, network, or computer peripheral.

POTS (Plain Old Telephone Service): Traditional phone service that is found in most homes and businesses. POTS is in contrast to advanced services such as ISDN and DSL, which are digital and provide greater bandwidth.

Power Down: To turn off the power. A system is normally powered down when replacing a card. Powering up will generally cause the system to restart or reboot.

Power Supply: A sub-component found in most computers and switches, which converts 120 Volts AC (alternating current) to the DC (direct current) voltages required by the unit to operate. Note that some computers or switches are designed to connect directly to DC power, in which case an external DC power source is needed.

PRI-ISDN (Primary-Rate Interface ISDN): A high capacity version of ISDN that allows for twenty-three main channels (for voice, fax, or data) and one data channel (primarily for control purposes).

Printed Circuit Board / Printed Circuit Card: a card containing the electronic circuitry required to perform a specific function. Printed circuit cards are used throughout computers and switches (see Card).

PROM: Programmable Read Only Memory (see Firmware).

Protocol: an approved and time-tested tool used by telephone triage practitioners. It can be paper-based or computer-based, depending on the application.

Predictive Dialer: a device that automatically calls a list of telephone numbers, screens out disconnected numbers, answering machines, and busy signals, then connects the called party to a call center agent. A predictive dialer improves call center and agent efficiency, by increasing the number of contacts per hour over other means.

Protocol: An approved and time-tested tool used by telephone triage practitioners. It can be paper-based or computer-based, depending on the application.

PSTN (Public Switched Telephone Network): The traditional international telephone system in which phone calls are switched or routed from origin to destination. This is in contrast to private networks and dedicated point-to-point services.

Quality Assurance: a process to assure that calls follow established guidelines and instructions, meet ethical expectations, and are in compliance with legal requirements.

Queue: A stack of calls on hold, or ringing, and waiting to be answered. Most call centers make use of a queue for increased agent efficiency and productivity.

Remote Agent: a call center agent who works outside of the actual call center, but is connected to it and available to process calls, just is if on-site. Remote agents can work from home or from a strategically located ancillary site (see Home-Based Agent).

Rep: short for Representative; another name for Agent.

Restart: To force a component to re-initialize itself by reloading software, clearing memory, or some similar function. It is the same as boot, re-boot, or reset.

Retention Rate: the percentage of a call center’s agents who remain with the call center over the course of a year (contrast with Turnover Rate).

Ribbon Cable: a flat, ribbon-like cable used to connect different components or boards in a system.

RJ-11 (Registered Jack 11): A standard modular jack used for to connect a single phone line. In alternate variations, it can also handle two or three lines.

RJ-45 (Registered Jack 45): A standard modular jack used for many computer network connections. It can accommodate eight wires, although all eight may not be used or needed in certain network configurations.

SaaS (Software as a Service): see ASP

Screen Pop: In CTI (Computer-Telephony Integration) applications, causing a computer to display information about the call at the same time as the CSR answers the call.

Snail Mail: A derogatory term for traditional mail service that was spawned by the Internet age. Given the speed at which email messages can be sent and received, regular mail moves at a snail’s pace in comparison.

Speech Recognition: software capable of recognizing spoken language; it may also be able to translate the spoken word into written text (compare to Voice Recognition.)

SS7 (Signaling System 7): A sophisticated telecommunications protocol that provides out-of-band signaling and a data interface between phone company switches for the express purpose of reducing congestion in the PSTN (Public Switched Telephone Network). For example, without SS7, a long distance call is routed through the network to the called party to make their phone ring or before a busy signal can be returned, thereby tying up circuits along the entire path. With SS7, once the call is dialed, the data interface sends a message to the end switch to ring the phone or to check if the called party is busy before the call is routed. If the call is answered, it is then immediately routed though the network, thereby not using the circuits while the phone is ringing or in busy and no-answer situations.

Surge Suppressor: An electronic device that limits the damaging effect of surges on electronic equipment from commercial power plants, generators, and electrical storms. All important or expensive equipment should be plugged into a surge suppressor.

Switch: A generic name referring to any device that can connect lines or trunks and route calls from port to another. It can be analog or digital. Digital is more advanced and produces higher quality connections that are less prone to noise. See ACD and PBX.

Switched 800 Service: In the past all 800 numbers required expensive dedicated lines. With switched 800 service, the long distance company routes 800 calls to existing local telephone lines. This is efficient and cost-effective for low volume applications. Also, since 800 numbers cannot have call forwarding on them, the switched 800 service can effectively be rerouted by forwarding the local lines they ring in on. Contrast to Dedicated 800 Service.

T-1: In common usage T-1 is a designation for a high speed, four-wire data circuit that can accommodate up to 24 separate audio channels. Technically, T-1 is the medium and DS-1 (not to be confused with DSL) is the format, though in many instances the terms are used interchangeably. A T-1 circuit is also a common high-speed Internet connection.

T-3: In common usage, a designation for a very high speed, four-wire data circuit that can accommodate up to 28 T-1 circuits, which is 672 separate audio channels. Technically T-3 is the medium and DS-3 is the format, though in many instances the terms are used interchangeably. A T-3 circuit is also used in connecting to the Internet backbone and even for some Internet backbones.

Telco: Short for Telephone Company.

Telecommunications: Communications that take place using the telephone or telephone network.

Telecommuting: using telecommunication technology, such as the Internet, to work outside of the traditional workplace; remote call center agents are a growing class of telecommuters.

Telemarketing: Sales and service conducted using the telephone. It is classified as inbound or outbound. See inbound telemarketing and outbound telemarketing.

Telemessaging: The act of answering a call, taking a message, processing that information, and relaying it to the client.

Telephone Answering Service: A business that handles calls for clients at a central location, whereby a client’s phone is answered, a message is taken or information provided to the caller, and the results are documented and provided to the client. Many telephone answering services also provide voice mail service and enhanced services, such as order taking.

Telephone Triage: The provision of basic medical assistance and preliminary diagnosis over the phone by a trained medical practitioner using an approved resource, often called a protocol.

Telephony: A term used to refer to telephone lines, trunks, circuits, related equipment, and the information (voice, fax, and data) that is transmitted over them.

Telephony Switch: See switch.

Teleservice Agency / Company / Provider:  See Outsource Call Center

Test Set: Also called a butt-set or butt-in; it is used to test telephone lines, trunks, and circuits.

Text Chat: An Internet service that allows two (or more) users to type messages and immediately send to each other. Text chat is a real-time communication; compare to email, which is not. Instant Messaging (IM) is a subset of text chat.

Third-Party Verification: after an agent completes a transaction (typically a sale), the caller is transferred to a third person, normally outside the call center, to verify the veracity of the transaction.

Touch Tone: A dialing method that uses tones as opposed to dial-pulses. Today most phone lines are designed for touch-tone dialing (which is faster and more reliable). Many touch-tone lines will also accept dial pulse signaling, but this is not always the case. Touch-tone is a trademark of AT&T; the generic name is DTMF.

TSR (Telephone Sales Representative): A term commonly used in the telemarketing and call center industries for employees who proactively place calls to customers or prospects to obtain data, share information, or sell products and services. See agent and contrast to CSR. Some define TSR to stand for Telephone Service Representative, though CSR is a more universally accepted term for that context.

Turnover Rate: sometimes called the churn rate, the percentage of call center agents who leave during the year (contrast to Retention Rate)

Unified Messaging: A system that allows voice mail, email, and faxes to be received, stored, and retrieved from a common system using various interfaces, including a phone, fax machine, or computer.

UPS (Uninterruptible Power Supply): A device that supplies continuous power to computers and switches by converting energy stored in batteries to 120 Volts AC. Commercial power is used to charge the batteries. In the event that commercial power is lost, a UPS will provide power until the batteries run down, commercial power is restored, or a generator is turned on. In many installations, a UPS is used for short-term outages and gives time for the generator to be started and stabilized to power equipment during prolonged power outages.

Virtual Agents: call center employees who work from their own homes or decentralized locations as opposed to a centralized location (see Virtual Call Centers). Virtual agent does not imply the replacement of people with technology.

Virtual Call Centers: a call center not bound by a physical location and able to be extended to practically anyplace that is accessible via telecommunications or the Internet (see Virtual Agents.

Virtual Hold: a call center technology useful when the number of incoming calls exceeds the number of available agents. Rather than wait on hold, callers can hang up the phone – while maintaining their place in the queue – and then receive a callback when it is their turn to talk to an agent. Some virtual hold systems also provide callers with the “estimated wait time,” which provides an accurate prediction of when they will receive their return call. Virtual queuing increases customer satisfaction and agent efficiency, while reducing Average Speed to Answer (ASA), abandon rate, and toll charges for the contact center.

Virtual Queuing: see Virtual Hold

Voice Logging: Recording phone calls in a call center. Voice logging systems can be hardware based or software only. Most systems record only agent phone calls, whereas others record all audio continuously. Some systems can be linked to call records and even screen displays to provide a complete picture of the phone call. Voice logging is useful for call verification, agent training, and customer service resolution. In some industries voice logging is required. Also, laws regarding the legality of voice logging vary from state to state and country to country.

Voice Mail: A device that plays announcements to callers, records messages, and allows the messages to be retrieved. There are hundreds of different voice mail systems, each with slightly different features and user interfaces. Many newer voice mail systems provide aspects of unified messaging, which allow voice mail, email, and faxes to be handled on a single platform.

Voice Recognition: software capable of recognizing a specific person’s voice, thereby confirming identity (compare to Speech Recognition.)

Voicemail: a device that plays announcements to callers, records messages, and allows the messages to be retrieved. There are hundreds of different voicemail systems, each with slightly different features and user interfaces. Many newer voicemail systems provide aspects of unified messaging, which allow voicemail, email, and faxes to be handled on a single platform.

VoIP (Voice Over IP or Voice Over Internet Protocol): Using the Internet to send voice signals or phone calls. Also referred to as Internet Telephony or IP Telephony.

WAN (Wide Area Network): a network of computers dispersed over a large geographical area and interconnected via the various telephone or Internet connections.

Web Callback: a feature that enables a person visiting a website to a phone call from that company. The request can be for an immediate callback or scheduled for a later time.

Web-Enabled Center: a call center able to conduct business using Internet features, such as email, callback, co-browsing, and live chat.

Workforce Management Software: software that allows call center managers to more effectively balance optimal staff levels, anticipated call traffic, campaign timetables, agent availability, and infrastructure capacity. Most workforce management programs also generate agent schedules, accommodating agent preferences, as well as track attendance, including absences, late arrivals, early departures, and even schedule swaps.

24 x 7: A notation to indicate continuous operations, twenty-four hours a day, seven days a week. Most teleservice companies and outsourcing call centers operate 24 x 7.

66 Block: a passive device that provides a connection point for telephone lines and trunks. Often it is divided in the middle and both sides are connected with bridge clips. The bridge clips serve as the point of demarcation (“demark”) between the telephone company and the customer’s equipment.

Peter DeHaan is the publisher and editor-in-chief of AnswerStat magazine and a passionate wordsmith. Connect with him on his personal blogs, social media sites, and newsletter, all accessible from

[From the Winter 2004 issue of AnswerStat magazine]

An Eye For Customer Service

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

It was an emergency run to the eye doctor. Being far-sighted and using a computer all day makes my glasses an indispensable tool – one that I treat with the utmost care. Imagine my dismay when in the midst of my morning cleaning routine, I heard the frame snap and a lens landed in my hand. I was panic-stricken. How would I be able to get any work done?

I arrived at my optometrist’s office, practically as the doors opened, glad that they would take a “walk-in.” I explained the situation and although they treated my disaster with matter-of-fact routine, I was comforted that they were willing to help. “We’ll need to order new frames,” the man concluded.

“Can’t you simply fix them?” I inquired.

“We could,” he droned, “but there is no guarantee…it might hold a day, maybe a few months. Don’t worry,” he added, “we’ll get you some loaner frames to use while you wait for your new ones.” Trusting his advice, I assented.

He disappeared into a back room and returned several minutes later. The look on his face braced me for bad news. “Your frames have been discontinued. We’ll have to fix your old ones…they can be soldered.” Now I have done my share of soldering over the years: in electronics to make an electrical connection and in plumbing to seal a joint. I was highly skeptical that solder would repair my damaged frames for more than a few minutes. I began to voice my apprehension. He smiled assuredly and clarified. “Actually, it’s more like welding.” Now I knew he was off base. During a stint working at a machine shop, I did more types of welding than most people know exist. I did not see any of those methods successfully repairing my delicate wire-rims. But I was out of options and reluctantly consented. He quickly outlined the details: the broken frames would need to be sent out for repair…they’ll be back in a few days, maybe by Saturday…it would cost twenty dollars.

He then set about finding a loaner frame. After half an hour with no success, he finally uncovered one old demo pair that, although not the right dimensions, would at least hold my lenses in place and keep them approximately positioned in front of my eyes – the temple pieces were much too short, which tipped the lenses forward, throwing off the bifocals. I would need to adapt. Grateful for a solution, albeit uncomfortable and less than ideal, I reminded myself that it was only for a few days and gratefully thanked him. His parting promise was clear; “We’ll call you when your frames come back – let’s hope for Saturday.”

As I left, I confirmed the plan at the front desk, “Yes,” she affirmed, “We’ll call you when they come in.” I believed her.

Saturday came but without a call. Monday they were closed. I called them on Tuesday. I got an answering machine. Dismayed that they did not answer their phone in the middle of the day, I left a message imploring them to call. No one called. Wednesday I called again. “Sure, they’re here,” she said cheerfully. “You can stop in any time,” she added, as though getting my frames back and returning my life to normal was a trivial and incidental matter.

By now, the tops of my ears were inflamed and the bridge of my nose tender because of the ill-fitting frames. “I’ll be there in twenty minutes,” was my firm and somewhat terse reply.

The man greeted me soon after I arrived. “It will only take a few minutes to switch lenses,” he said with a smile. I reminded him that the screws holding my lenses in my frames have a tendency to loosen and fall out. “Don’t worry,” he assured, “I’ll put in special screws with ‘lock-tight’ on them.”

“No,” I responded firmly, “you’ve done that before and they fall out too. Last time you said that you ‘glued them’.” I was dismayed that this critical information was not in my file, as he had re-installed my lenses four times in the past three years. He said nothing, but gave me a slight look of comprehension, retreating into his work area. A few minutes later, he returned and I donned my restored glasses; what a great feeling, it was just like slipping into a comfortable pair of old shoes!

I thanked him and segued to my next goal. “Will you please put my old lenses in another frame – any frame,” I inquired, “so that I can have a back-up pair?”

“Your frames have been discontinued,” he said, telling me what I already knew.

“Surely someone makes a frame that will fit my lenses,” I prodded.

“I already looked, remember?” Now he was becoming irritated with me. “You’ll need to order new frames and get new lenses, and before we’ll do that, you’ll need an eye exam.”

“That will be almost five hundred dollars,” I said in dismay, recalling the cost of my initial introduction to glasses. “I can only afford to buy a second frame,” I embellished.

“You really should have an eye exam every year,” he lectured. “And it’s been fourteen months for you.”

“I just want to buy a back-up frame,” I pleaded.

His reply was curt, “Sorry, we can’t help you.” He turned and walked away.

Later, I casually mentioned my ordeal – and desire for a back up pair of glasses – to my mother. Mom took this on as a personal challenge and the next day surprised me with a list of businesses willing to assist. Two days later, I visited the top one on her list.  Their office was closer, easier to get to, and had free parking at the door. I walked in, explained my plight to the receptionist, and shared my goal. I waited a few minutes and was greeted by a kind and empathetic young lady. She listened to my tale of woe, acknowledging that it, too, would have been their preference for an exam, new frames, and new lenses. Nevertheless, she said she would do her best to help me. She began to look for suitable frames and I realized her intent was to handle my request immediately. She came back with a frame that she thought would work with some adjustments or by grinding my lenses. I had not expected an immediate resolution and since there were several other customers waiting at the time, I told her that I would be more than happy to come back later. She thanked me and promised to work on my glasses first thing the next day; I could stop by any time. I believed her.

I returned the next afternoon. She recognized me and immediately approached me, smiling broadly. “I have your glasses done,” she beamed with the pride of an artist. “I am really pleased with how they turned out.” Because of her genuine sincerity, I knew that I would be pleased as well. She had not had to grind my lenses down after all. I was only charged for the frames, there was no labor fee, and I got a free case and a discount, too. I thanked her profusely. She said that she was glad she was able to help me.

On my prior visit, I had noticed a sign that gave their repair rates. To solder frames was only five dollars. My old optometrist had charged four times as much!  I realized that five dollars would not even cover shipping, so I reasoned that repairs were done in-house; I suspected I would not have to wait eight days either. I had already decided that they would be my new optometrist, but took one more step to confirm my decision. “By the way,” I inquired, “how much is an eye exam?” It was fifty dollars less than what I had been paying!  I promised her that I would be back.

By giving poor customer service, my eye doctor had lost a loyal patient; by going the extra mile, someone else had gained one.

How to Lose Patients, Clients, or Callers:

  • Act apathetic toward their situation
  • Make promises you don’t keep
  • Don’t listen to them
  • Lose credibility by making recommendations that are self-serving
  • Fail to keep good records of previous interactions
  • Give them a reason to check out your competition

How to Gain Patients, Clients, or Callers:

  • Be genuinely sympathetic, even if it is a routine matter for you
  • Only make promises you can keep
  • Take time to really listen to what they say
  • Gain credibility by going the extra mile
  • Make sure their interaction with you is pleasant and memorable
  • Give them a reason to never return to their old provider

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.

[From the Winter 2004 issue of AnswerStat magazine]

Case Study: QEII Health Sciences Centre’s Communications System

By Jane Doucet

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.

[From the Winter 2004 issue of AnswerStat magazine]