SLUCare Physician Group Case Study
SLUCare is operating in a fiercely competitive St. Louis region marketplace and was keen to differentiate themselves from local competition by providing exceptional patient contact center solutions. Due to sub-optimal technology platforms and poor processes, the organization was working without clear visibility to key metrics such as call volumes, call types, call dispositions and other pertinent patient access data.
For example, in SLUCare’s General Internal Medicine department leadership noted that they were suffering from extremely high Abandonment Rates, upwards of 50%, along with poor results in other Key Performance Indicators (Answer Rates, Scheduling Accuracy, Average Handle Time, etc.). In addition, clinic-based staff were overwhelmed with their workload which included providing patient facing customer service, appointment scheduling, prior-authorization support amongst various other ad hoc tasks. This inferior performance was evident across the organization and SLUCare engaged the services of RelateCare to assist them in improving the efficiency of their patient access, appointment scheduling, and call center operations.
First, RelateCare’s performed a diagnostic deep dive including a ‘- Turning on the Lights’ phase – to fully understand the nature of the improvement opportunities in scheduling and contact center operations. This involved gathering data on several Key Performance Indicators within the small original call center, across several key areas, so that a clear picture of the processes and workflows was developed.
Following this deep dive, RelateCare developed a series of optimization workstreams focusing on people, process and technology. These included Telephony Optimization, Scheduling Optimization, Referral/Authorizations Optimization, Employee Engagement and Nurse Triage. RelateCare also worked with SLUCare Leadership to establish the finalized future state vision for a centralized contact center (SLUCare Central) serving the needs of the entire organization and bringing together several functions under a single department.
SLUCare Central Vision: The mission of SLUCare Central is to improve patient access, patient experience and quality of care by enhancing and simplifying access to the appropriate physician or service within the SLUCare Physician Group.
Optimizing Referrals: Managing the physician referral process can help a hospital reduce emergency department wait times, cut costs, engage physicians and improve patient satisfaction.
Enabling Infrastructure and Technology: The staff in SLUCare Central were trained extensively on a range of key technology systems in use throughout the health system such as:
- Guided Scheduling Questionnaires
- Single sourced and version controlled to maintain a consistent and unified process across all agents. All pertinent data from each clinic is maintained by Master Schedulers and Subject Matter Experts as they liaise with clinical resources. Future State includes a centralized master scheduling team under SLUCare Central.
- Command Center Operation
- From Quality Control to Staff/Capacity Forecasting and Real Time analysis, SLUCare Central continuously monitors agent performance to ensure effective and consistent patient experiences on each and every call.
- Standardized Menu Trees
- Patients require consistent experiences regardless of the facility or department they contact. SLUCare Central’s standardized menus enable connectivity to the right resource at the right time.
Measuring Success / Reporting: Quality Assurance has the patient experience at its core – empathy, patient engagement and soft skills are utilized to ensure the patient experiences the best possible service when contacting SLUCare Central.
The Best Practice metrics for patient scheduling measured at SLUCare Central throughout each day are:
- Average Speed to Answer (ASA) = <30s
- Call Abandonment Rate = <5%
- Scheduling Accuracy = 98%
- First Call Resolution = 80%
- Appointment Conversion Rate = 50%
- Quality Assurance = 90%
The Quality Assurance metrics for referrals and prior authorizations measured at SLUCare Central throughout each day are:
- Urgent = 24 hours
- Routine = 48-72 hours
- Quality Assurance = 90%
Areas Supported by SLUCare Central
During Phase I of the SLUCare Central implementation, the following services were centralized:
- Patient Scheduling – SLUCare Central enables patients to call and schedule an appointment with any of the centralized providers.
- Referral Scheduling – Referral Scheduling within SLUCare Central enables providers to submit referrals for patient appointments without requiring additional effort by the patient.
- Prior Authorizations – SLUCare Central Prior Authorizations support each centralized practice with coordination of the required prior authorizations of the various insurance payors.
- Master Scheduling – SLUCare Central Master Schedulers enables standard and optimized work flows in conjunction with each of the centralized practices, ensuring standardized optimal SLUCare Central processes are maintained.
During Phase II of the SLUCare Central implementation, the following services are expected to be added, further improving the patient experience and gaining efficiencies for the SLUCare practice:
- Pre-Arrival Team – The SLUCare Central Pre-Arrival Team will save time for both the patient and the SLUCare provider, with required demographic, payment, medication, allergy, medical history, etc. information being documented directly into the patient’s electronic health record by SLUCare Central staff at the time of the patient’s registration so that less data entry is required by the provider during the patient’s visit.
- Nurse Triage – SLUCare Central Nurse Triage will enable patients to engage with a medical professional to better determine the type of care they require.
Impact on Business (see: http://www.slucare.edu/central/ )
- Increased patient and staff satisfaction by supporting administrative and clinical duties in a centralized location.
- Improved clinic staff opportunities to provide direct patient care and practice at the top of their licensure, certification and skills.
- Improved the patient experience by removing obstacles that stand in the way of patients getting the care that they need.
- Optimized Referral processing helps reduce wait times and lower costs.
SLUCare General Internal Medicine Case Study: https://catalyst.nejm.org/holistic-approach-patient-access/
SLUCare General Internal Medicine Success Video Townhall 2017: https://www.youtube.com/watch?v=0tL-H3XdSTA&feature=youtu.be
In 2018, staff increased the number of answered calls by 13.5 percent while simultaneously increasing scheduled appointments by 13.8 percent
- Average time to answer calls decreased from 58 to 28 seconds, Abandon % < 5%
- Total Annual Reimbursement Change – 2016 à 2017 = $263,669