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Medina Healthcare System: Centralized Scheduling Center

Medina Healthcare System: Centralized Scheduling Center. Inbound Calls. Patient calls. 30 sec. Automated message. Schedule apt.?. Yes. Scheduler available?. No. Yes. No. Placed at the back of queue. Take message?. Yes. Wait ≤7min?. Scheduler greets patient. No. Yes.

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Medina Healthcare System: Centralized Scheduling Center

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  1. Medina Healthcare System: Centralized Scheduling Center

  2. Inbound Calls Patient calls 30 sec. Automated message Schedule apt.? Yes Scheduler available? No Yes No Placed at the back of queue Take message? Yes Wait ≤7min? Scheduler greets patient No Yes Transfer call to hospital department Physician to Physician No Rolled to registration Get up and find physician Get up and find MA Pharmacy to Physician Patient calling MA to return call Call picked up? Yes No Process Flow Chart: Scheduling Center Inbound Calls

  3. Inbound Calls Cont. Process Flow Chart: Scheduling Center Inbound Calls (Continued) Problem w/insurance New patient? Verify Insurance Yes Yes No Patient on hold No Input info Re-schedule/ Schedule follow-up Schedule patient Call insurance company/verify Immediate doc. contact? Input message Yes Call doc No Forward doc message/ printer Call patient back

  4. Data Analysis June 1, 2012 – May 30, 2013

  5. Data Analysis June 2013

  6. 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

  7. Data Analysis July 1 – July 23rd

  8. 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

  9. Mean shifted from 5:00 in June to 4:30 in July

  10. Mean shifted from 5:00 in June to 4:30 in July

  11. Hypothesis • Ho: June and July cycle times were essentially the same • Ha: June and July cycle times were significantly different

  12. 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

  13. Comparison of Cycle Times

  14. 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%

  15. 2nd Hypothesis: Ho: Regardless of the call type, data is essentially the same Ha: Call cycle time is significantly different between call types

  16. Call Type/Location/Time Interval Data – July

  17. 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

  18. The Path Forward • Develop reports that track call center data. Enabling us to analyze performance and continually make improvements • Create weekly and monthly goals for scheduling center staff • Improving patients satisfaction through decreased wait times and a more consistent scheduling process • Ensure changes and improvements are sustained through monitoring the process using statistical process control charts and re-evaluating every quarter

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