Transcript Slide 1

Medina Healthcare System: Centralized
Scheduling Center
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Inbound Calls
Patient
calls
30 sec.
Automated
message
Scheduler
available?
Schedule
apt.?
Yes
No
Yes
No
Placed at the
back of
queue
Wait
≤7min?
Take
message?
Yes
Rolled to
registration
No
Call
picked
up?
No
Scheduler greets
patient
Transfer call to
hospital
department
No
Get up and find
MA
Yes
Yes
Physician to
Physician
Get up and find
physician
Pharmacy to
Physician
Patient calling
MA to return call
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Process Flow Chart: Scheduling Center Inbound Calls
Inbound Calls Cont.
New
patient?
Yes
Verify
Insurance
Problem
w/insurance
No
No
Input info
Re-schedule/
Schedule followup
Schedule
patient
Input
message
Yes
Immediate
doc.
contact?
Yes
Patient
on hold
Call
insurance
company/v
erify
Call doc
No
Forward doc
message/
printer
Call patient
back
Process Flow Chart: Scheduling Center Inbound Calls (Continued)
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Data Analysis
June 1, 2012 – May 30, 2013
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• Average queue time per 15 minute time
interval
Data
Limitations
• Average service time per 15 minute time
interval
• Reduces variation; data in the tails
• Does not include the time the patient
spends on “make busy”
• Calls interflowed that return to the
queue are then tracked as if they are
new calls
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Data Analysis
June 2013
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June - Record of changes made
04/2013: Added phone tree.
Issues: Incorrect routing, Took too long to get through the
phone tree. Interflow noted as a problem
06/01/2013: Took out phone tree, routing to physician line
removed
Issues: Interflow a continued problem
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Data Analysis
July 1 – July 23rd
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July - Record of changes made
06/29/2013: Added physician phone number to beginning of automated
message.
7/01/2013: Removed interflow completely. Began using referral center
staff during peak times (Mornings)
7/02/2013:
Radiology dept. staff began giving patients in need of follow-up
appointments the radiology scheduling line while reminding them not
to call the clinic scheduling line for these appointments
Clinic scheduling center staff began sending emails to employers
requesting information needed to process workman’s comp claims
Started using Recondo. Avoiding the rework of pasting information
into templates previously entered – Faster insurance verification
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Process Capability of Converted
USL
P rocess Data
LSL
*
Target
*
U SL
0.004
Sample M ean
0.00312725
Sample N
36
StDev (O v erall) 0.000354939
O v erall C apability
Z.Bench 2.46
Z.LSL
*
Z.U SL
2.46
P pk
0.82
C pm
*
0.0024
O bserv ed P erformance
% < LSL
*
% > U SL 0.00
% Total
0.00
0.0028
Exp. O v erall P erformance
% < LSL
*
% > U SL 0.70
% Total
0.70
0.0032
0.0036
0.0040
Mean shifted from 5:00
in June to 4:30 in July
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Mean shifted from 5:00
in June to 4:30 in July
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Hypothesis
• Ho: June and July cycle times were essentially the same
• Ha: June and July cycle times were significantly different
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Hypothesis Testing
Two-sample T test for Cycle Time vs Cycle Time1
N Mean StDev SE Mean
Cycle Time 36 0.003477 0.000304 0.000051
Cycle Time1 36 0.003127 0.000355 0.000059
Difference = mu (Cycle Time) - mu (Cycle Time1)
Estimate for difference: 0.000349
95% CI for difference: (0.000194, 0.000505)
T-Test of difference = 0 (vs not =): T-Value = 4.49 P-Value
= 0.000 DF = 68
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Comparison of Cycle Times
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Other important numbers…
Average Delay to Abandon
2012-2013: 1:45
June 2013: 2:03
July 1-23rd 2013: 2:01
Calls abandoned
2012-2013: 21.47%
June 2013: 23.73%
July 1-23rd 2013: 17.59%
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2nd Hypothesis:
Ho: Regardless of the call type, data is essentially the same
Ha: Call cycle time is significantly different between call types
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• Manually tracked
• Not all calls fit cleanly into a category
Data
Limitations
• Time includes service time but not time
spent waiting
• Time does however include time spent on
“make busy”
• Data sampled from 3 different time
periods on 6 different days
• No interflow point
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Call Type/Location/Time Interval
Data – July
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Call Type
Pa
140
120
100
80
60
40
20
0
100
80
60
40
20
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tie
Re
Count
Percent
Cum %
54 25 15
14
8
7
6
5
2
39.7 18.4 11.0 10.3 5.9 5.1 4.4 3.7 1.5
39.7 58.1 69.1 79.4 85.3 90.4 94.9 98.5 100.0
0
Percent
Count
Pareto Chart of Call Type
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Take Aways
It is vital that systems are in place to accurately report on performance of the call
center. Times need to include “make busy” and at least include a range or standard
deviation for the wait time and service time per time interval
Seemingly minor changes in the processing of calls makes a significant impact
– Interflow point removal
– Recondo – eliminate rework
– Workman’s comp calls
Adjusting staffing for peak times will reduce time spent waiting
– Referral coordinators used during peak times
Potential improvements:
Designate a staff member to focus only on insurance verification during peak times
Redesign how messages for physicians are processed
18% of calls in July were from patients who were calling to leave a
message for their physician
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The Path Forward
1. Develop reports that track call center data. Enabling us to
analyze performance and continually make improvements
2. Create weekly and monthly goals for scheduling center staff
1.
Improving patients satisfaction through decreased wait times and a
more consistent scheduling process
3. Ensure changes and improvements are sustained through
monitoring the process using statistical process control
charts and re-evaluating every quarter
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