- CATEGORIES: Accountable Care Organizations (ACOs),Charu Raheja, PhD,Technology for Providers
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How to Manage Patient Calls Based on the Size and Needs of Your Organization
As a practice manager or doctor, managing patient calls effectively is critical in ensuring high-quality, well-coordinated care for every patient. The first step is to make sure that the people answering your phones triage patients efficiently and effectively. Establishing a consistent nurse triage system will improve the way you manage patient calls. This is even more imperative if your practice is part of an Accountable Care Organization (ACO), as nurse triage allows for more efficient use of healthcare resources.
The benefits of nurse triage include: better patient access, coordinated care, and cost savings.
In addition, it gives patients better access to providers even if they are not seeking emergency care. This can improve patient satisfaction, prevent future complications, and allow providers to educate patients.
However, with the evolution of new technology there are several cost-effective options available for nurse triage services. Here, we will detail three options available for setting up a nurse advice line, including:
- Do it yourself in-house (and hire your own nurses)
- Outsource to a nurse triage center
- Use a combination of in-house and outsourcing
1. Do it Yourself In-house: Start Your Own Call Center
Starting your own call center involves setting up the call center infrastructure. The requirements depend on the scale and number of calls received. For daytime calls, many practices choose to have their own staff nurses take calls using daytime triage protocols. These protocols are available in book form or in electronic format, such as TriageLogic’s myTriageChecklist. For night calls, the requirements include hiring an experienced call center manager, purchasing triage software for night-time protocols (such as TriageLogic’s Call Center Solution software), and hiring clinical and non-clinical staff to answer the phones and handle patient phone calls.
Pro: Having your own system also gives your staff the flexibility to perform multiple tasks in addition to triage, such as physician referrals, scheduling, disease management, class registration and surveys.
Con: Setting up a call center requires a high initial investment. It is labor intensive for the nursing department, and it requires human resources and IT involvement. Moreover, there are significant differences in terms of hardware requirements and capabilities with various software programs, so it is important to do your research and speak with a variety of vendors. This is a long-term project with a slow return on investment.
The organizations most likely to succeed with this approach are larger organizations with high call volumes, who expect to handle over 50,000 triage calls a year. These companies are the right fit because they already have some call center infrastructure and they just need to add to it. The high call volume also allows the center to use nurses’ time efficiently.
2. Outsource to a Nurse Triage Center
If the thought of setting up your own call center seems too daunting, you could use an outside vendor for your patient calls, such as Nurse Triage On Call. The vendor provides access to a call center infrastructure that patients can call to and have access to a nurse when they have clinical questions and concerns.
Pro: This option has a relatively low upfront start-up cost. Your practice would not need to train nursing staff and there is no need for human resources and IT staff. Since the outside vendor is already taking calls, start up is quick and there is an immediate return on investment. In addition, vendors may have more experience and expertise in the niche area of triage, resulting in better care for your patients.
Con: When outsourcing your patient calls, you will have less direct control over the nurses and some nurse triage vendors cannot integrate with Electronic Medical Records.
For the best outcome, you need to be very careful about interviewing vendors and make sure that you are comfortable with them. In addition, costs may vary significantly depending on the vendor and while you “get what you pay for” you get less from some than others. Still, assuming you have done your homework in interviewing and discussing costs, outsourcing can be a good option for small to medium size practices.
3. Use a Combination of In-house and Outsourced Services
This is a model in which an organization uses its own nurse triage software and nurses during high call volumes and outsources the triage to a service during low call volumes. This combination can be accomplished seamlessly with the call center technology, integration engines, and communication platforms available today.
Pro: A combined nurse triage model can improve services and decrease costs. Most triage centers lose money when the call volume is very low because nurses are sitting idle waiting for phone calls. By outsourcing during those low volume times, the call center can continue to provide service at a reduced cost. Your organization can continue to provide the same level or increased levels of service, and at the same time decrease your operating costs to work within a given budget. It also allows organizations to keep their current infrastructure and resources. Under this option, your practice may also be able to expand into other areas of call center work to increase revenues.
Con: Just as in the previous option, it is important to take the time to find the right partner with the technology and service-level knowledge to implement a combined model. There can be an interruption in patient care if their system does not align with yours.
This model is best for organizations that have some existing nurse triage infrastructure and are being faced with budget cuts. Physicians also have their own practice-specific needs, and those requests need to be followed by both parties consistently. Therefore, it is crucial to select your partner carefully. Make sure you interview and discuss your software and services with your partner before making a commitment.
Each patient encounter starts with a phone call. Make sure that your nurse triage service, whether in-house, outsourced, or a combination, is a seamless experience for your patient.
It is important for you to examine your options for managing those patient calls and find the solution and product that aligns with your needs.
For more information on what nurse triage is and how it works, download our eBook “Telephone Nurse Triage Handbook.”