The document summarizes a presentation by Tina Minnick on enhancing patient satisfaction, safety, and risk management through medical call centers. The presentation discusses the impact of healthcare reform on accountable care organizations and traditional and innovative solutions for medical call centers. It provides examples of using post-discharge calls and social media to improve patient outcomes, satisfaction, and reduce risks. The presentation emphasizes using call centers to focus on quality, leadership, and core competencies in a changing healthcare environment.
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Enhancing patient satisfaction, safety, and risk management through medical call centers
1. Maryland MGMA
Enhancing patient satisfaction, safety,
and risk management through
medical call centers
September 24, 2010
presented by
Tina Minnick, Director of Business Development
TeamHealth Medical Call Center
1
2. The insults ―moron,‖ ―idiot,‖
―imbecile,‖ and ―cretin‖ were all
once official medical diagnoses.
- Balderdash & Piffle, BBC 2
2
3. Today, we will talk about:
• Healthcare reform impact
• Accountable Care Organizations
• Traditional & Innovative solutions bringing it
all together
3
4. Resources
• TeamHealth
– Dr. Gar LaSalle, Chief Medical Officer
– TeamHealth Midsouth
• HFMA
• AHLA Connections
• Facebook and Twitter
• Studer Group
4
6. Healthcare Statistics
• National Health Care was in excess of $2.9 trillion
in 2009, (an average of $9,300 per person, per
year)
• Health Care spending is 4.3 times National Defense
spending
• The average cost per family for health insurance in
2006 was $11,500
• It is estimated that Health Care Fraud in the U.S. is
over $50 billion each year and rising
6
7. Healthcare Statistics
• Medicare is among the top three
Federal programs with improper
payments, totaling an estimated
$10.4 billion/3.6% of the total
improper payments in 2008.
• Medicare pays without looking
therefore, potential for waste,
fraud and abuse are high.
7
9. Healthcare Reform Goals
• Reduce costs with goal to assure
affordable coverage, and:
– Invest in prevention & wellness
– Improve safety and patient care
9
10. What does this mean for you?
• Creating a financial sense of urgency:
– Revenue growth
– Focus on value
– Identify improvements that enhance quality while they
drive down cost
• Growing the patient experience:
– Quality outcome & high-touch experience
• Opportunity to ask questions:
– ‗Why do we do it this way?‘
– ‗Why aren‘t we doing this?‘
10
12. Accountable Care Organizations
• Getting started
– Target market
– Local ACO?
– Reimbursement structure
– Identify patient-related strategies
– Identify organizational strategies
12
13. Accountable Care Organizations
• Managing risk and the market place
– Timely information
– Who does what?
– Cost to begin an ACO/ongoing costs
– Which physicians will participate?
13
23. Innovation—Twist on Community Outreach
and Class Scheduling
Combined with social media, can be a
new way to approach the market
23
24. Hospitals and Social Media
• At least 540 hospitals are using social media
in the United States
• Hospitals account for:
– 247 YouTube channels
– 316 Facebook pages
– 419 Twitter accounts
– 67 blogs
24
34. ―Patient safety is at the core of every health
care provider‘s mission. And unless there is
tort reform, you must also address patient
care from a risk management standpoint.‖
— Dr. Gar LaSalle, CMO
TeamHealth
34
36. Innovation—Patient Satisfaction,
Safety and Risk Management
• Post Discharge Calls
• Who should make these calls?
– Emergency Department
– Inpatient
– Outpatient
– Other
36
38. What should Post Discharge calls include?
• Follow-up PCP appointment?
• Do you understand your discharge instructions?
• Did you receive the follow up care you needed?
• Have your symptoms subsided? Any new
symptoms?
• Document, document, document
38
39. Annals of Internal Medicine,
February 2003
Type of Adverse Events
“Nearly 1 in 5 patients”*
Other
400 patients surveyed Fall
8%
76 (19%) had adverse
events after discharge Nosocomial 4%
Infection 5%
Adverse
Procedure Drug
Related
17% 66%
Event
* 81 events occurred in 76 patients
* 81 events occurred in 76 patients
“Adverse Events After Discharge from Hospital”
* “Adverse Events After Discharge from Hospital”, Annals of Internal Medicine,
February 2003
40. State University of New York Study Mayo Clinic
Proceedings, August 2005
• Only 28% knew medication names
• Only 37% knew purpose of medication
• Only 14% knew side effects
State University of New York Study Mayo Clinic
Proceedings, August 2005
41. What else should Post Discharge Calls include?
• Concern
• Compassion
• Care
• Help the patient move forward with next steps
in care process
41
42. Examples of outbound Post Discharge ED Calls
• AMA‘s
• Falls by the elderly and the young
• Patients who may be a concern because of
confusion or dementia
• Patients who are not
appropriate for admission
• Pediatric discharges with
a high fever but no other
serious symptoms
42
43. Specific ED risk management discharge calls
• TIA‘s
– Some will have an adverse
event within 2 – 5 days
43
44. Specific ED risk management discharge calls
• Abdominal pain – when the
cause hasn‘t declared itself at
time of discharge
44
45. Post Discharge Call benefits:
• Reduce non-reimbursable readmissions
• Patient safety
• Patient satisfaction
• Reduce risk
• Brand presence
• Best allocation of resources
45
46. Additional Post Discharge Call - Benefits
• Clinical Quality
• Reward and Recognition
• Reconfirms discharge instructions
• Reduces patient anxiety
• Reduces complaints and claims
• Reinforces patient perception that excellent care has been
provided
• Process Improvement
47. Post Discharge Calls
and HCAHPS
Seven composites:
• Nurse communication (Q 1–3)
• Doctor communication (Q 5–7)
• Responsiveness of hospital staff (Q 4, Q 11)
• Cleanliness, quiet of hospital environment (Q 8-9)
• Pain management (Q 13-14)
• Communication about medicines (Q 16-17)
• Discharge information (Q 19-20)
48. Post Discharge Calls
Likelihood of Recommending – Inpatient
“Likelihood of Recommending”
100 98 98 99 98 98 98 99
90
80 75 76
70 64
60 62
Percentile Rank
60 56 59
50
40
30
20
10 No No No No No No No
Call Call Call Call Call Call Call Call Call Call Call Call Call Call
0
3Q06 4Q06 1Q07 2Q07 3Q07 4Q07 1Q08
Source: New Jersey Hospital, Total beds = 775 Studer Group
No Call Call
Source: New Jersey Hospital, Total beds = 775
49. Post Discharge Calls
Likelihood of Recommending - ED
“Likelihood of
Recommending”
100 95 93 93
88 87
90
80 76 77 76
70
70 62 63
Percentile Rank
60
47 47
50
38
40 32
27 29
30 25
20
10 No No No No No No No No No
Call Call Call Call Call Call Call Call Call Call Call Call Call Call Call Call Call Call
0
1Q 06 2Q06 3Q06 4Q06 1Q07 2Q07 3Q07 4Q07 1Q08
Source: New Jersey Hospital, ED Visits: 85,034, Total beds = 775 Studer Group
No Call Call
Source: New Jersey Hospital, ED Visits: 85,034, Total beds = 775
50. Post-Discharge Calls:
Impact on Complaints
Cleveland Clinic Foundation, Cleveland, OH
• Compliments increased from 28% to 78%
• Patient complaints decreased from 20% to 2%
Source: Cleveland Clinic, Total beds: 1,000
56. Challenges and Learning Experiences
• Highly organized program
• Managing data and delivery
– Frequency
– Benchmarking
• Reminder:
– Coaching and motivational tool
– Not a replacement tool for formal surveys
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57. Benefits
• Improved patient satisfaction?
– Sometimes, not always
• The big picture: LEADERSHIP
– ED is the front door for the hospital
– Coaching for clinicians
– Building a culture through encouragement
– Accountability
57
58. Overall, why is it important?
• Leadership
• Brand Marketing
• Service Recovery
• Tool for your clinicians
– Recognition
– Customer happiness
– Loyal customers
58
60. Reform and Accountable Care
• Healthcare Reform and ACO‘s will cause us to be
more proactive:
– Patient care and safety
– Reimbursement strategies
• Quality outcomes
• Patient satisfaction
– Revenue Growth
60
62. What can you do?
• Traditional approaches:
– Community Line
– Physician After-Hours
– Class Scheduling
– Physician Referral
• Innovative approaches:
– Post Discharge Calls
– Patient satisfaction calls
– Leverage your social media strategy
62
63. Who else might you want to engage?
• CMO
• CNO
• Others
63
64. What should you look for in a
medical call center?
• Comprehensive programs (clinical & non-clinical)
• Partnership
• URAC accredited
• Quality program
• Physician oversight and leadership
• Employ nurses and representatives
• Respected triage guidelines, e.g. Schmitt - Thompson
• Robust training program
• Reporting
• Why? So you can focus on your core competencies
64