Using an Outsourced Telephone Triage Service for Suicide Prevention


TriageLogic

By Ravi K. Raheja, MD

Telephone triage nurses play a critical role in suicide prevention and serve as the first point of contact for callers in need of immediate assistance. According to the CDC, 123 Americans die by suicide every day, and for every person who dies from suicide every year, another 278 people think seriously about it but don’t kill themselves.

As the demand for mental health services grows, practices are turning to outsourced telephone triage call centers to support their practices. Call center triage nurses trained in treating patients with mental illnesses are better prepared to intervene and often alleviate lengthy interruptions to the normal call flow of a practice.

Common Warning Signs Of Suicide

  • Talking about wanting to die or to kill oneself.
  • Looking for a way to kill oneself.
  • Talking about feeling hopeless or having no purpose.
  • Talking about feeling trapped or being in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious, agitated, or reckless.
  • Sleeping too little or too much.
  • Withdrawing or feeling isolated.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

What Can Triage Nurses Do to Help?

Triage nurses need to find a connection with the patient. They combine both clinical judgment and emotional connections. Click To Tweet

In moments of crisis, connecting with a trained triage nurse can deescalate the suicidal crisis and provide immediate help. It is never easy to talk about suicide, but it is crucial for triage nurses to be comfortable talking about suicide in the same way they talk about chest pain. How they handle each call can be life-changing for the caller.

Triage nurses need to find a connection with the patient, find the patients local emergency assistance numbers, and be ready to involve all resources available to help prevent this patient from harming him/herself.

It is essential for the triage nurse to be sympathetic, non-judgmental, and accepting. The caller has done the right thing by getting in touch with another person. No matter how negative the call seems, the fact that it exists is a positive sign, a cry for help.

Triage nurses always have the caller’s safety in mind. They combine both clinical judgment and emotional connections to assess the patient’s situation to identify possible mental health issues.

Even though remote triage nurses typically can’t see their patient, they must develop that all-important trust quickly and by means other than visualization for the caller to open up and be honest with the nurse. Not all patients can accurately describe their condition, history, medical conditions, or other pertinent information. The telephone triage nurse must decipher this uncertainty.

Sometimes the patient needs emergency treatment, while other times they are reaching out for someone to talk with and work thru difficult situations like substance abuse, economic worries, relationships, sexual identity, getting over abuse, depression, mental and physical illness, and loneliness.

Just talking about their problems for a length of time gives some suicidal caller’s relief from loneliness and pent up feelings, an awareness that another person cares, and a sense of someone understanding them. Also, as they talk, they get tired and their body chemistry changes. These things take the edge off their agitated state and help them get through a bad night. Suicide calls can be difficult, but with proper training, protocols, and disposition, telephone triage nurses save lives, one call at a time.

TriageLogic

Ravi K. Raheja, MD is the CTO and medical director fo the TriageLogic Group. Founded in 2005, the TriageLogic Group is a URAC accredited, physician-lead provider of high quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group assists their clients with value based care and serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com. and www.continuwell.com.

The April/May 2019 Issue of AnswerStat

Read the April issue of AnswerStat, the information hub for healthcare contact centers.



Feature Content:

April 2019 AnswerStat

Homelessness in America: How Can Your Contact Center Help?, by Traci Haynes
Homeless individuals are at a relatively high risk for a range of acute and chronic physical and mental illnesses. Contact centers can help healthcare organizations address this need.… read more >>

Vital Signs: Provide Meaningful Agent Benefits to Improve Agent Retention, by Peter Lyle DeHaan, PhD
When it comes to retaining call center staff, don’t skimp on benefits. This will increase their loyalty and decrease the likelihood of them leaving for another company that does provide these benefits.… read more >>

Vendor Spotlight on TriageLogic
Providing quality medical call center that patients can access 24/7 is a great first step in transitioning to value-based care. Providers and hospitals can then gather information from callers to further improve their service while containing costs… read more >>

Guest Column: Where Was the Call Center in Our Time of Need? by Mark Dwyer
Why had the hospital not taken the initiative to begin using the call center to support transitional care?… read more >>

Healthcare Call Centers Help Bring Care to the Medically Underserved, by Nicole Limpert
Medical call centers play a critical role in helping to serve the medically underserved, by addressing two of the biggest barriers to healthcare: language and transportation.… read more >>

How Call Centers Can Add Value to Wellness Programs, by Janet Livingston
Wellness programs empower employees to improve their health and help companies hold down costs. To maximize the results of a wellness program, tap a full-service call center to add value.… read more >>

Oklahoma Medical Center Provides Innovative Triage Line to Manage Hospital Overcrowding, by Charu Raheja
Providing local communities with a nurse triage program reduces unnecessary ER visits, saves on healthcare costs, and helps patients get appropriate care when a serious symptom arises.… read more >>

Tips to Selecting a Vendor—Don’t Compromise on Security, by Ravi K. Raheja, MD
Compare vendors before selecting one that will protect your patient data properly. It’s a lot harder to change vendors once you implement a program, so don’t be afraid to dig deeper to find the best system in place for your needs.… read more >>

Ten years ago: Managing Outbreaks: The Technological Approach, by Dr. Jean Challiner
When it comes to dealing with a health pandemic, healthcare call centers can play a key role in reducing its spread.… read more >>

Industry News

        

Call4Health      TriageLogic

1Call      Startel

TeamHealth Medical Call Center      Ambs Call Center

AAACN       Citra Health Solutions

Call Center Sales Pro, providing proven healthcare call center solutions      Pulsar360


About AnswerStat
AnswerStat is the information hub for healthcare contact center news and resources, published specifically for hospital and medical contact centers and distributed free to qualified readers, decision makers, and influencers at hospitals and healthcare contact centers worldwide.

Contact us for more information.

Vendor Spotlight: TriageLogic


TriageLogic


Using Data Analytics to Improve Value-Based Care

As practices and organizations move to value-based care, medical call centers can play a crucial role in improving the patient experience and the quality of care while containing costs. An effective way to find a solution is to evaluate data from nurse triage call centers on patient concerns, caller demographics, nurse triage disposition and effectiveness, and other measures to improve the call center and the patient experience.

Value-based programs focus on the quality of the care given, rather than fee-for-service. Ensuring patients receive the right level of care for their symptoms is an important action to decrease healthcare waste. Providing a quality medical call center that patients can access 24/7 is a great first step in transitioning to value-based care. Providers and hospitals can then gather information from the patient callers to further improve their service while containing costs.

Studies show that incorporating data analytics into value-based care programs can reduce healthcare spending by $300 billion. Healthcare providers need to be able to gather, analyze, and report on patient data to show they are improving the quality of care. This quantitative method is especially important in medical call centers. Call center software should include a data portal to easily evaluate key metrics to spot trends or areas needing improvement.Value-based programs focus on the quality of the care given, rather than fee-for-service. Click To Tweet

Gather Data

For new call centers and those selecting a new platform, start by evaluating data you’ve already collected and what you need to know to help the patients and the practice. For example, TriageLogic’s data portal collects information on the number of calls per protocol, calls per nurse, dispositions, and disposition override. Call centers also get data on nurse performance, such as the number of calls per hour and percentage of patients told to seek emergency care. Information on nurse performance provides a valuable tool to evaluate nurses and determine the focus of further training.

Analyze Data

While gathering the data is a crucial first step, the platform also needs to have a simple dashboard for the manager to monitor the key metrics of patient calls and nurse performance. For example, the TriageLogic data dashboard allows the user to break down the data by date, location, nurse, and so forth. Reviewing the various data sets can help caregivers gather insight on the performance and find ways to improve care.

For example, with the data dashboard, users can see the percentage of the dispositions given to the patient callers. Users can also see the actual data as the number of calls and the percentage of the total, as well as graphs that illustrate any trends of the different disposition percentages.

Report on Data

After analyzing the data from medical call centers, physicians or organizations can better understand their patient population. Look for a quality call center platform that allows call center managers to easily export the information in various formats and then share it with their practices. This is an important feature to improve coordinated care between the office and the call center.

Physicians can see what concerns their patients have after-hours and make positive changes that can address those concerns ahead of time. For example, an increase in stomach pain related issues may mean that a virus is hitting their population.

Another important use of data is to compare the number of patients you prevented from going to the ER. The number of those patients shows how much value the call center is creating for the practices (ROI), and it may motivate hospitals and providers to continue encouraging patients to call a nurse line before going to the ER.

Secure Data

When collecting patient data, it is vital that all data from the call center software be fully secure and that products are evaluated and updated as technology and standards change. When evaluating call center software, make sure you understand how it stores and secures patient data. Also, ensure you can share the information with providers securely or without any PHI.

The goals of value-based care are to provide better care for patients, create a healthier population, and reduce healthcare costs. A nurse call center system armed with good data analytics allows you to identify the quality of the clinical call center and improve the efficiency of the nursing staff while helping patients at the same time. Having access to this data, analyzing it, and sharing the information with providers improves patient care, while at the same time showing the value of your call center service and saving valuable healthcare dollars.

TriageLogicFounded in 2006, TriageLogic is a URAC accredited, physician-led provider of high-quality services and software for telehealth. TriageLogic is a leading provider of top-quality triage technology, mobile applications, and call center solutions. The TriageLogic group serves over 9,000 physicians and covers over 18 million lives nationwide.

Is It Time to Start a Medical Answering Service?

How to Start a Telephone Answering Service, by Peter Lyle DeHaan, PhD

Get the latest info in the book How to Start a Telephone Answering Service.

Industry veteran Peter Lyle DeHaan released his insider’s guide to starting an answering service earlier this year. How to Start a Telephone Answering Service concisely shares the essential information needed to start an answering service. Based on decades of industry experience and years of consulting for hospital communication centers, healthcare call centers, and medical answering services, Peter Lyle DeHaan, PhD, released this book as a service to the industry.

“I open the book trying to talk people out of starting an answering service. If they decide to proceed, I want them to do it right and not damage the industry by making naïve mistakes,” said DeHaan. It’s an essential resource for anyone thinking about starting a medical answering service.

“When I consulted for the industry, people kept asking for information on how to start an answering service. I repeated the same advice so often, that I eventually to putting it online.” Since day one that website received steady traffic. Now, for the first time, that updated information is available in a book. Available in paperback and e-book. Learn more at www.StartAnAnsweringService.com.

Healthcare Call Centers Help Bring Care to the Medically Underserved



By Nicole Limpert

A person medically underserved, is someone who does not have health insurance. Estimates from the Centers for Disease Control and the National Health Interview Survey cite that in 2017, 29.3 million, or 9.1 percent of the population were uninsured.

Vulnerable Populations: Multiple studies have found that vulnerable populations in the United States, including the elderly, low-income, ethnic minorities, migrants, and people who received limited education, are also medically underserved.

People with various life experiences may interpret symptoms differently, such as thinking a seizure is a spiritual issue rather than a medical complaint, or expressing concerns about depression as anger rather than sadness.

Poor Access to Healthcare: Living in a rural location and having inadequate transportation present challenges when trying to access healthcare. Rural areas are sparsely populated, resulting in a lack of available services. Rural communities comprise roughly 20 percent of the United States, yet less than 10 percent of doctors practice in these communities.

People in rural areas rely on their own transportation to and from health services. A report released in December 2018 from Pew Research Center, found the average travel time by car, to the nearest hospital for rural Americans, is about 17 minutes compared to 10 minutes in urban areas.

However, even people in urban areas have difficulty visiting their doctor’s office. Transportation can be a challenge for people with disabilities, those with chronic illnesses, the elderly, and people who are low-income. Approximately 3.6 million Americans, from both rural and urban areas, experience missed or delayed medical appointments due to transportation issues.

Medical call centers play a critical role in helping to serve the medically underserved. Click To Tweet

Support from Healthcare Call Centers

Technology enables medical call centers to effectively become an extension of a hospital or clinic’s operations. The communication software used by medical call centers can securely access a patient’s electronic medical record (EMR), update EMRs with notes, and record calls needed for insurance claims and workmen’s compensation. Because everything is documented, detailed reports can be generated for reporting purposes.

Medical call centers can provide or facilitate healthcare-related services 24 hours a day, 7 days a week. They play a critical role in helping to serve the medically underserved, by addressing two of the biggest barriers to healthcare: language and transportation.

Language: Healthcare staff work with an enormously diverse patient population. Understanding a person’s language leads to better healthcare. Multi-lingual call centers hire operators to assist non-English speaking patients or use confidential over-the-phone interpreting (OPI) services for access to hundreds of different languages.

Transportation: Patients with mobility challenges or who live in rural areas don’t have to leave home for some services. Operators can coordinate care, make follow-up calls, schedule visits, contact on-call medical staff, and manage referrals.

Some call centers staff nurses or multidisciplinary teams (such as a resident, pharmacist, and social worker) who are qualified to make health assessments, give medical advice, and escalate critical concerns. These call centers can offer nurse call helplines, emergency mental health counseling, and other critical support.

Helping Hospitals that Help the Underserved

Reduce Penalties: A recent study done by Harvard suggests that hospitals located in low-income areas are more likely to receive penalties due to Medicare and Medicaid’s survey-based reimbursement programs. Patients are asked to provide information about their healthcare experience via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Unacceptable survey outcomes can result in hospitals losing some reimbursements.

The American Medical Association Journal of Ethics reports that the Centers for Medicare and Medicaid Services (CMS) can currently withhold one percent of Medicare payments—30 percent of which are tied to HCAHPS scores. When Medicare and Medicaid account for more than 60 percent of all care provided by hospitals, the possible amount of dollars lost due to poor patient experience is a significant number. In 2017 alone, approximately 1.7 billion dollars in reimbursements were withheld from hospitals.

Healthcare call centers play a critical role in patient satisfaction surveys, because they function as a virtual lobby for a hospital and are often the first point of contact with a patient. The patient’s experience with coordinating their care via call center agents can positively affect their feedback on the survey.

Reduce Readmissions: The CMS reports that nearly one in five Medicare patients are readmitted to a hospital within 30-days of discharge, yet a recent study from the University of California San Francisco (UCSF) and published in JAMA Internal Medicine found that twenty-seven percent of all 30-days hospital readmissions are preventable.

Medicare’s Hospital Readmissions Reduction Program (HRRP) lowers payments to Inpatient Prospective Payment System (IPPS) hospitals who report too many readmissions. According to the CMS, 2,573 hospitals received penalties in 2018 and had around 564 million dollars in payments withheld.

Studies indicate that a post-discharge call program can help hospitals reduce their readmission rate. IPC Healthcare (IPC) tested the effect of post-discharge calls on readmission rates from October 2010 through September 2011. The IPC call center contacted 350,000 discharged patients to check symptoms, review medications and treatment plans, and remind patients of follow-up appointments. Successful contacts occurred with thirty percent of patients, with an estimated 1,782 avoidable readmissions prevented over that year.

1Call, a division of Amtelco

Nicole Limpert is the marketing content writer for Amtelco and their 1Call Healthcare Division. Amtelco is a leading provider of innovative communication applications. 1Call develops software solutions and applications designed for the specific needs of healthcare organizations.

Where Was the Call Center in Our Time of Need?


LVM Systems

By Mark Dwyer

This story hits close to home, because it involves my family members. I share it to illuminate where the call center is failing its customers. Today’s call center can offer supportive resources and referrals to patients and their caregivers and ensure that interventions are applied as needed. That is what coordinating care and managing transitions is all about. It is not necessarily about a specific disease, but it’s more about the patient’s and family’s needs.

If you ever had to move a loved one into a long-term care facility, you know how incredibly hard it can be. Especially when all your loved one really wants is to simply stay or go home. I’ve had to deal with this situation now three times in my life. First with my mom as she suffered with Lewy Body Disease, then dad with Alzheimer’s, and last week with my dear little brother as he is in the final stages of Early Onset, Frontal Lobe Dementia.

His is the cruelest of all. Not only was he afflicted with this terrible disease at such a young age, he’s now just fifty-eight years old, but it is a horrifying disease for all whose lives are touched by it. At this point, his disease causes him to rarely sit still. He paces the halls, head bent downward. His navigational skills are amazing. But what is he seeing, what is he processing? His vocalizations fluctuate between quiet utterances to loud vulgarities and heinous, hateful words spewed upon his loving wife. She does her very best to comfort him despite occasional punches, attempts to choke her, and comments more vile than one would say to their worst enemy.

What makes this even worse is that my brother was never an angry, nasty man. Quite the opposite. He was the life of the party, always the kidder, the storyteller, the embellisher. He never met someone he did not greet with a smile.

But that was then, and this is now. This past week, I saw everything from enormous amounts of love and compassion, to raw agony on the face of my sister-in-law. I saw complete confusion and despair on the face of my brother. If I had a mirror, I most certainly would have seen overwhelming sorrow on my own.

Where Was the Call Center?

I could not help but wonder as I was loading my brother into my sister-in-law’s SUV moving him from the psych ward to a supposedly “qualified” dementia nursing care facility 2.5 hours away, where was the call center?

Why had my sister-in-law never spoke with someone in the call center about how best to transfer him? How to get him into the car without a struggle or to distract him along the way? How to help him with the transition into new surroundings? Before we set off on our road trip, why hadn’t someone from the call center reached out to the new care facility and asked the hard questions to determine if they were qualified to accept and care for my brother? Why?

I have not spent over half my life in this industry to have it fail me now. Why had the hospital not taken the initiative to begin using the call center to support transitional care? Who better than skilled nurses trained to ask probative questions and educated to listen between the answers? Why hadn’t experienced call center staff been brought into the fold to offer this much needed service to the community? Surely, my sister-in-law or I would have paid for such a service. We cannot be the only ones who would.

Unfortunately, there was no call center support. My sister-in-law and I loaded my brother into the car and began our 2.5-hour transition to the dementia nursing care facility without educational or emotional support.

Fortunately, after years of caring for my brother, his wife smartly knew to bring a few items to distract him along the way. For the most part, he was content to play with a stuffed animal that reminded him of his cat. The trip progressed uneventfully.

When we arrived at the facility, there was no one to greet us. Instead, a kind young lady led us to an area where patients were eating lunch. Not the best way for my brother to start his new life. Too much confusion, too many people all looking at him. Too many strangers.

Eventually, they showed us his room. My sister-in-law had brought many of his toys, pictures, wall hangings, blankets, etc. As she made up his room, I joined my brother in his thousand-step trek around the facility. Not only does he like to walk, he likes to walk fast, a challenge for an older brother with a bad hip. We walked, and we walked, and we walked, occasionally setting off door alarms if I failed to redirect him in time. Meanwhile, my sister-in-law completed all the needed paperwork. Again, why didn’t the call center complete this prior to our arrival?

After an inordinate amount of walking, all the paperwork was completed (again paperwork that should have been coordinated and completed in advance of our arrival) and we were able to get my brother to settle down in his room.

Or so we thought.

We had been with him for most of the day, so we decided to head home before dark set in. We made one last stop at the nurses’ station to confirm they felt comfortable caring for my brother. That they felt they had adequate staff and resources to provide him with the care we expected.

Leaving Too Soon

With their assurances, we headed home. As we began our 2.5-hour return trip, my sister-in-law and I discussed how we felt my brother would do. As we began to convince ourselves that he’d be fine, the phone rang. It was the dementia care facility. We had travelled for less than thirty minutes and already the nurse was calling us to come back and get my brother. He was scared and agitated in his new surroundings, and when they tried to calm him, he swung at one of the staff. That’s all it took.

We turned around, reloaded his things, and headed back to the psych ward from whence he had come, feeling totally defeated. There had clearly been inadequate transitional care support. Not enough questions had been asked. My brother’s specific needs and issues were either not communicated or were not fully understood by the care facility agreeing to take him.

To add to our frustration, when we arrived back at the hospital, the less than friendly security guard informed us that the hospital could not, and would not, admit my brother unless he was willing to choose to admit himself. Mind you, we are talking about a man who has only fleeting moments of cognitive lucidity, and this guard wanted him to state he desired to be checked back in. Again, a perfect place for someone in the call center to have assisted in his transition back to the psych ward.

My sister-in-law lost it. She returned to the car, violently sobbing, determined to simply take her husband home and care for him herself. As she pulled away from the hospital, I reasoned with her explaining that there was no way we could take care of my brother at home by ourselves, and that with me leaving town the next day, there certainly was no way she could do it herself.

When it finally dawned on her that she had no medicines for my brother, she realized we had to return to the hospital. Fortunately, at her request, this time nurses from the psych department came down to the ED bay and facilitated getting him checked in and back to the same room he had left merely ten hours earlier.

Ten hours I will never forget.

LVM Systems

Mark Dwyer is a thirty-three-year veteran of the healthcare call center industry. He currently serves as COO of LVM Systems.

“Transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location. Representative locations include (but are not limited to) hospitals, sub-acute and post-acute nursing facilities, the patient’s home, primary and specialty care offices, and long-term care facilities” (Coleman & Boult, 2003, p. 556).

a.   Transitional care is based on a comprehensive plan of care and the availability of health care practitioners who are well-trained in chronic care and have current information about the individual’s goals, preferences, and clinical status.

b.   It includes logistical arrangements, education of the individual and family, and coordination among the health professionals involved in the transition.

c.   Transitional care, which encompasses both the sending and the receiving aspects of the transfer, is essential for persons with complex care needs (Coleman & Boult, 2003).

Homelessness in America: How Can Your Contact Center Help?


LVM Systems-homeless population

By Traci Haynes MSN, RN, BA, CEN, CCCTM

Homelessness in America occurs in every state and has many causes. According to the January 2017 Point-in-Time (PIT) count by the National Alliance to End Homelessness, the most recent national estimate of homelessness in the United States identified 553,742 people experiencing homelessness. The PIT count is acount of sheltered and unsheltered homeless persons on a single night in January. Like all surveys, the PIT count has limitations. Results are influenced by the weather, availability of overflow shelter beds, the nature of the volunteers, and the level of engagement of the people being interviewed.

Most of this population lives in some form of shelter or transitional housing. However, approximately 35 percent live in places not meant for human habitation. The nature of homelessness makes it difficult to quantify the true size of the homeless population, not to mention the Point-in-Time methodology (although generally acknowledged to be the most accurate way to establish valid trend data). It is challenging to calculate the exact number of individuals who are homeless, because many live in hidden areas in parks, vehicles, or abandoned houses, and because numbers fluctuate, based on weather.

Homeless individuals are at a relatively high risk for a range of acute and chronic physical and mental illnesses. Click To Tweet

Health Problems Faced by the Homeless

Homeless individuals are at a relatively high risk for a range of acute and chronic physical and mental illnesses. Some health problems precede and may contribute to homelessness, while others are often a consequence of being homeless. And homelessness complicates treatment of many illnesses.

One example of a health problem that can cause homelessness is a major mental illness, such as schizophrenia. Without therapeutic interventions and supportive housing arrangements, such an individual may become homeless.

Another example is an accidental injury, including job-related injuries. Even with benefits under employer programs, these individuals may experience major economic costs leading to loss of housing.

Diseases of the extremities, skin disorders, malnutrition, degenerative joint diseases, dental and periodontal disease, communicable diseases, and the possibility of trauma are other health problems that may result from, or frequently occur in, the homeless population. Medical care and treatment for acute or chronic illness can be extremely difficult.

Bed rest may be non-existent for a homeless individual who has no bed or only has a bed in a shelter at night. Special diets and medication adherence are impossible to maintain for a person who is homeless.

Contact centers have long been known for assisting their organizations in offering triage, coaching, remote patient monitoring, and care management for an identified population. Some contact centers have also assisted other community agencies or services in filling a need or gap.

Triage Call Centers Can Help Address Health Concerns of the Homeless

So we all know homelessness exists, and it is a tremendous problem, but what does that have to do with triage call centers?

A community triage contact center at EvergreenHealth in Kirkland, Washington implemented a program around 2000, in which they began to offer low-level acuity triage for their regional 911 dispatch centers. The dispatchers would go through their algorithms with the caller, and once they ruled out any emergent or urgent issue, the caller was offered the option of speaking with a nurse. If the caller preferred, she or he could be connected with an appropriate unit or the individual could be transported to the Emergency Department (ED). This program proved a huge success in both caller/patient satisfaction and dollars saved.

A study was published in 2015 for a comparable 911 program in two cities with similar outcomes. Fort Worth, Texas (MedStar) provided nine months of 911 call data, and Louisville, Kentucky (LMEMS) provided thirty-four months of 911 data. The study reported that the 911 program had a significant reduction in callers routed to the Emergency Department (ED) at a cost savings of 1.2 million dollars in payments, as well as a decrease in emergency ambulance transports resulting in a cost savings of 450,000 dollars, and a resultant increase in access to alternative care. Overall, patient satisfaction was 91.2 percent.

As a result of the involvement with the regional 911 dispatch centers, the contact center was asked to become involved with yet another identified need: The growing population of homeless individuals. County shelters and housing facilities for the homeless population needed a resource for individuals with low to moderate acuity symptoms, when medical/nursing personnel were not on site. The fire department was handling 90,000 incidents per year, which resulted in overuse or misuse of the emergency medical response (EMR) system. And while the county shelters were not the majority of the calls, they were a contributor.

Addressing the Concerns of the Homeless

A very important concern to the homeless individual is whether they will lose their shelter bed for the night, if they are transported. The fire department is not authorized to make a medical diagnosis on the scene, to provide advice or guidance about disease management, to make a referral to other medical resources, such as a primary care doctor, or to provide transportation anywhere except an ED.

The contact center had the system and tools in place to assist the RN with the individual at the county shelter’s assessment and make recommendations of care. “Right care, right place, right time,” which is the fundamental premise of contact center RN triage. Their service provided a much-needed solution to an ongoing gap in care. They currently support five dispatch centers in providing contact center RN triage for thirteen shelters.

The contact center educated the staff at the shelters and facilities. They provided training on when to call 911 (a red flag list), and when to call the contact center’s health line. Each homeless individual received HIPAA information that included “understanding and agreement that a copy of the information discussed during the call interaction would be shared with the residence so that they may further assist the individual with their care.”

The workflow included one number for all facilities to dial into the Healthline contact center. The case manager and the resident had to be available at the time of the call. The RN in the contact center triaged the individual, and then the case manager determined the best non-EMR transportation based on the disposition. The triage note was then faxed to that facility.

Challenges included the individual wishing to remain anonymous, the individual being a vague or poor historian, individuals declining triage or the recommendation, availability of OTC meds, and their psych/social needs.

The Results

Eighteen months after the start of the program, the facility staff was queried, and all were either very or somewhat comfortable in knowing what situations required 911. Over 85 percent of the staff felt the service was very important to the facility.

By far, the majority felt the nurses at Healthline were very knowledgeable (83.33 percent). Beyond 85 percent also felt the nurse line process was easy-to-use, and felt the residents were satisfied with the service. Most of the staff felt very satisfied once the resident had talked with the nurse, and 100 percent indicated the importance of having the service available 24/7, adding that it was practical and helpful to the residents in the facility.

LVM Systems

Traci Haynes MSN, RN, BA, CEN, CCCTM is the director, clinical services at LVM Systems, Inc. and has been involved in the contact center industry for over twenty-five years. (Traci thanks Cheryl Patterson, BSN, RNC—TNP, clinical manager—quality and education, Healthline, for her contributions to this article.)

Provide Meaningful Agent Benefits to Improve Agent Retention



Spend More on Retaining Staff and Less on Hiring and Training Their Replacements

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

We’ve looked at five tips to better retain call center staff. Agent compensation is first on most people’s list. However, it might not be the most important item, merely the one most cited. Pay rate alone isn’t enough to keep most call center agents happy and employed. Other items factor into this equation. A related issue is benefits. Today’s workers expect more than decent pay. They expect benefits too. This includes part-timers. Yes, your part-timers deserve benefits. If you want to keep them, you better provide what they want.

Paid Vacation

Your agents work hard for you and your callers. They deserve a vacation. This gives them a break from the routine of work, provides something for them to look forward to, and helps them recharge. A paid vacation is the top benefit employees seek. Be sure to provide it to them, both full and part-timers.

(As with all benefits for part-time agents, make it proportional to the average amount of time they work. For example, if they work twenty-hours a week, their vacation pay should be based on a twenty-hour workweek.)

Paid Time Off

Next up is paid time off. This includes sick days and personal days. Ideally, we want healthy employees who don’t get sick and who schedule their appointments on their days off. But this isn’t always feasible. Failing to provide paid time off could result in an agent coming into work sick or not attending to some important personal issue, which could have negative consequences later.

Retirement

Though not every employee thinks about retirement, some do. And for those who do, it’s of critical importance. They want to take control of what their retirement looks like, and that means planning for it now, regardless of how far away it is. Be sure to offer them the option to set money aside now for their retirement.

An employee with the opportunity to learn more, will provide more value to your organization and be more loyal. Click To Tweet

Continuing Education

Next up is the ability to pursue ongoing education. As with retirement, this isn’t a benefit that most people seek or will use, but for those who want it, it could make the difference between them quitting or staying. Tailor your program so that it provides value to participants and to your organization too. Also include a reasonable precaution to avoid abuse, but be fair. An employee with the opportunity to learn more, will provide more value to your organization and be more loyal.

Healthcare Coverage

The last significant benefit is healthcare coverage. Healthcare coverage is a growing concern for people in the United States. The cost rises and the coverage shrinks. Yet being in the healthcare industry, we’re in the unique position to help our agents with decent healthcare coverage, or at least we should be.

Conclusion

When it comes to retaining call center staff, don’t skimp on benefits. Offer them paid vacation and time off, retirement and continuing education options, and healthcare coverage. This will increase their loyalty to your organization and decrease the likelihood of them leaving your call center for another company that does provide these benefits. Just as with compensation, the cost of providing benefits concerns most managers. The key is to offer what you can without jeopardizing your organization. But if you think you can’t afford to offer benefits, the reality is that you can’t afford not to.

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.

How Call Centers Can Add Value to Wellness Programs


Call Center Sales Pro, providing proven healthcare call center solutions

By Janet Livingston

Wellness programs allow an employer or healthcare plan to provide participation incentives to members. These incentives may include cash awards, gym memberships, and premium discounts. Some popular options provided by wellness programs include smoking cessation, stress management, weight loss, and diabetes management.

Wellness programs have the direct goal of helping participants move into a healthier lifestyle, with reduced healthcare concerns. The indirect goal is lower healthcare costs. These benefit everyone: the employee, the company, and the healthcare provider.

Wellness programs can tap call center services to better achieve these two goals and add value to their program. Here are some things that a call center can provide to enhance a wellness program.

Wellness programs empower employees to improve their health and help companies hold down healthcare costs. Click To Tweet

Telephone Enrollment

Though most signups for wellness programs happen online, this isn’t a solution for everyone. Some people feel more comfortable talking with a real person over the phone and others have questions. And what happens to those people who can’t access the web form or encounter problems once they get there? Provide a ready solution for these people by offering the option to enroll over the phone.

Class and Event Registration

Most wellness programs offer various classes and events to their participants. These might include stress reduction classes or a 5k race. Just as with enrollment, signing up for classes and events mostly happens online. But this solution won’t work for everyone. That’s why providing alternative phone backup is the way to go to help maximize participation.

Web Chat

Another service call centers can provide to wellness programs is offering web chat capabilities. When a website visitor doesn’t see the option they want or can’t find the answer to their question, help is a click away with web chat. From a technical standpoint, adding a web chat option to a website is easy. Staffing it around-the-clock is hard. That’s where a call center comes in. They’re available 24/7 to help participants anytime of the day or night.

Class and Appointment Reminders

Just because someone signed up for a class or made an appointment doesn’t mean they’ll show up. No-shows result in inefficiency and cause a financial loss for the provider, as well as accomplishing nothing for the participant. Making strategic reminders to participants by phone, email, or text will help increase their commitment and ensure their participation. It’s an easy solution for your call center to provide and pays off huge.

24/7 Availability

People increasingly expect 24/7 customer service and support. This is challenging for any organization to offer and cost prohibitive to provide in house. Yet a call center already has staff in place, so extending around-the-clock availability to program participants is a cost-effective solution.

Multi-Channel Access

We’ve talked about self-service over the internet and personal service over the phone. Yet there are other communication channels available for people to use. Why not let them use their channel of choice? This might include email, text messaging, or social media. A full-service call center is already set up to use these communication channels, so why not extend these options to your program participants?

Conclusion

Wellness programs empower employees to improve their health and help companies hold down healthcare costs. To maximize the utility and results of a wellness program, tap a full-service call center to add value. A call center can handle telephone enrollment, offer class and event registration, and provide web chat. They can also remind participants of classes and appointments. In addition, they offer 24/7 availability and multi-channel access, which will delight participants and increase their involvement. This improves health outcomes and saves money.

Call Center Sales Pro, a full-service healthcare call center consultancy

Janet Livingston is the CEO of Call Center Sales Pro, which provides medical answering service and healthcare call center services. Contact Janet at contactus@ccsp.us or call 800-901-7706.

Oklahoma Medical Center Provides Innovative Triage Line to Manage Hospital Overcrowding


TriageLogic

An Effective Approach to ER Phone Calls

Dr. Charu Raheja

Emergency Room (ER) overcrowding is widespread in hospitals, creating delays and diversion from those who need care the most. According to a recent article, “Compounding the problem is the alarming trend of a decreasing number of ERs and an increasing number of ER visits.”

All too often, injury or illness appears without warning for patients. For hospitals trying to control overcrowding, the obvious solution is to redirect patients who don’t need to be in the ER to more appropriate paths for care. Who then determines if it’s necessary for a patient to go the ER? Most people aren’t trained medical professionals, and as a result, they worry and end up in the ER for non-urgent symptoms.

Having the reassurance of a triage nurse could help decrease the number of people in the ER for non-emergency reasons. Click To Tweet

Patients faced with uncertainty about where to go, all too often, end up calling the ER department and receive a standard response: “We are not allowed to give advice over the phone. If you think you have an emergency, please hang up and call 911. If you think you need to see someone, you can come to the emergency room or call your doctor.”

So, who do you call?

Telephone Triage

One hospital in Oklahoma, with a similar issue, wanted to change this process. What if they provided a nurse triage line that would be available to receive calls from the patients calling the ER? Having the reassurance of a triage nurse could help decrease the number of people in the ER for non-emergency reasons.

This would provide patients with quick and easy access to a trained medical professional to assist in determining the appropriate next steps based on their symptoms and medical history. Also, since the nurses work independently from the hospital system, the nurses would provide an objective opinion increasing patient trust.

Results

The results were inspiring. The nurses significantly decreased unnecessary emergency room visits. A random survey of about 520 patients uncovered their plans before talking to a nurse. This helped determine the effectiveness of the system.

Out of 240 patients who were planning to go to the ER, 42 percent of them were diverted to a lower level of care, including 17 percent that received home care needing no additional follow up actions. This translated into a savings of at least 215,000 dollars in unnecessary ER visits, not to mention providing peace of mind for patients being able to stay home and rest.

Better Health Outcomes

The benefits didn’t just stop at ER costs savings. Consider the patients who called into the nurse triage line and were not intending to go to the ER. Some medical conditions are considered emergencies because they require rapid or advanced treatments.

Surprisingly, close to 20 percent of the patients who called into the nurse triage line had symptoms that were serious enough to warrant a visit to the ER. Without the nurse line, the outcomes for these patients could have been life threatening or fatal.

Conclusion

While nurse triage has shown significant effectiveness in an outpatient setting, this preliminary data shows even greater promise to expand this model to emergency rooms around the country.

Providing local communities with a nurse triage program not only prevents unnecessary ER visits and saves on healthcare costs, but it also ensures patients get appropriate care when a serious symptom arises. For the hospital, this increases goodwill in the community while addressing the overcrowding of the ER: a win-win all around.

TriageLogic

Dr. Charu Raheja is the co-founder and CEO of the Triage Logic Group. Charu’s personal struggles and triumphs with her health define both her personal and her professional mission. Most recently, her experience in overcoming a life-threatening health event led her to launch the Continuwell brand. The TriageLogic Group provides telehealth software, mobile communication solutions, and services to large medical centers and businesses around the country. It is part of the Women’s Business Enterprise National Council (WBENC), and it covers over 25 million lives nationwide. Visit www.TriageLogic.com or contact Amy Smith at 888-TEAMTLC for more information.

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