Jeff Kiser, Director, Managed Care Contracting

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Optimizing the Creativity Empowerment of Your
Employees for the Innovation of a Healthcare
System-wide Call Center

• Jeff Kiser, Director, Managed Care Contracting
  Communications
• Carolyn Knaup, VP Ambulatory Services
• Judy Orser, Planning Regulatory Consultant

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Purpose of Call Center

• To coordinate and enhance communications,
  patient flow, customer service and our ability
  to respond in the event of an emergency.

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Strategic Plan Goals
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Strategic Plan Goal Unsurpassed Service

• Improve patient flow processes and access to
  services. Minimize wait time and manage its
  negative effects.
• Develop a plan for improvements to system-wide
  communications for patient flow.
• Explore development of a centralized call center,
  including emergency communications, campus
  safety, mobile care, communications center,
  referral development center (channeling regional
  patients to the appropriate level of
  care/physician).

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Development Process
Stage-Gate Process
STAGE 4
STAGE 1
STAGE 2
STAGE 3
Concept Development
Planning
Design
Test/Refine
Launch
DFSS (DMADV) Tools
Measure / Analyze
Verify
Design
Define
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Methodology and Tools
DESIGN FOR SIX SIGMA
Under-standcustomerneeds andspecifyCTQs
Developdesignconceptsand high-level design
Developdetaileddesign andcontrol/testplan
Testdesign andimplementfull-scaleprocesses
Initiate, scope,and plan theproject
DELIVERABLES
TOOLS
? Mgmt Leadership ? Customer Research ? FMEA/Error
proofing ? Project ? QFD ? Process
Simulation Management ? Benchmarking ? Design
Scorecards
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Key Initiatives/Goals of the Project

• Review relevant services
• Assess viability of these services for a new Call
  Center
• Engage in process redesign of these services
• Research best practice organizations and
  incorporate findings into evaluation
• Evaluate staffing and skill level needs
• Create job descriptions for related staff
• Evaluate IT and telecom needs/requirements
• Study physical space needs and environments
  conducive to successful implementation of each
  service

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Project Phases

• Phase One
• Phase Two
• Phase Three

• Assessment of current services
• Subcommittee process improvement initiative
  preparation of business plan
• Facility and IT design, renovation, relocation of
  services

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Phase One Assessment of Current Capabilities

• Catalogued services offered, locations, FTEs,
  hours of service, IT applications, relevant
  statistics
• Best practice assessment
• Site visits NC Highway Patrol, Wake County 911,
  Guilford Medical Services Systems, Maryland
  Institute of Emergency Medical Services Systems,
  University of Maryland Medical Center, University
  HealthService Center (GA), Progress Energy
• Telephone interviews McLeod Health, Mountain
  States Health Alliance, Wachovia
• November 2005 - June 2006

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Services Under Review

• Scheduling - Surgical Services, Cath Lab,
  Neurodiagnostics, CV Testing, Sleep Center,
  Patient Access (Pre-Admission), Women's Services
  Pre-Admission Scheduling, Wake Faculty Physicians
  Appointment Scheduling, Radiology, Home Health,
  Outpatient Rehab, Birth and Parent Education,
  Corporate and Community Health Services, Diabetes
  Education Classes, Pediatric Diabetes Education
  Classes, Pediatric Asthma Classes, Cardiac Rehab
  Classes, Nutritional Counseling Classes
• Patient Placement Bed Board, Inpatient Rehab
• General Communications - Operators, Physician
  Referral Service, Pathology/Lab, Pediatric Triage
  Service, Billing Questions, IT Help Desk, Courier
  Services, Engineering Dispatch, Selected HR
  Services
• Emergency Services - Cary Hospital Police
  Dispatch, Raleigh Campus Police Dispatch, Mobile
  Dispatch, EMS Coordination

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Phase Two - PI Initiative

• Engaged NCSU facilitators with Six Sigma training
• Developed committee/subcommittee structure with
  monthly/weekly meetings
• Followed Baldrige format
• December 2006 May 2007

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Baldrige Principles

• 1.1 Leadership Mission and Vision
• 2.1, 2.2 Strategic Development and Deployment
• 3.1, 3.2 Customer and Market
• 4.1 Measurement, Analysis and Review of
  Organizational Performance
• 4.2 Information and Knowledge Management
• 5.1 Work Systems
• 5.2 Employee Learning and Motivation
• 5.3 Employee Well Being and Satisfaction
• 6.1 Value Creation Processes
• 6.2 Support Processes and Operational Planning

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Project Definition
Project Charter
Project Plan
Business Case
Project Execution Control
Project Initiation
Project Planning
Opportunity Analysis
inform, empower, sell
organize to execute
explore, justify, estimate
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Committee Structure
Steering Committee (26 members)
Scheduling (32 Members)
Pt. Placement (16 Members)
General Comm. (16 Members)
Emergency Svcs (15 Members)
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Standardized Meeting Structure

• Creation of meeting agendaTeam Leader and
  Facilitator
• Administrative support provided by facilitator
• Communication roll up and roll down
• Minutes weekly
• Newsletter, e-mails, etc.

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Expectations of Team Members

• Customer is 1 priority
• Be open to new ideas - positive attitude
• Attend meetings
• Meetings start and end on time
• Teams will establish additional ground rules

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Phase Two - Meeting Summaries

• December
• Held kick-off meeting
• January
• Reviewed project and subcommittee overview,
  expected timeline
• Developed future agendas based on Baldrige format
• Developed mission/vision statements
• Identified key customers and stakeholders
• Obtained voice of the customer feedback
• February
• Mapped current processes and ideal future state
• Determined negotiables and non-negotiables
• Identified facility needs
• Cataloged job classifications

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Phase Two - Meeting Summaries

• March
• Mapped FTE transition
• Developed IT needs/plan
• Determined leadership structure
• Developed proposed performance metrics
• April- May
• Wrote business plan and obtained approval to move
  forward

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Scheduling SubcommitteeMission and Vision

• Our MISSION is to develop a customer-centered,
  quality-driven design for all WakeMed Health
  Hospitals scheduling processes.
• We value and believe in exceeding
  customerexpectations through

• Personalized service
• System-wide coordination, collaboration and
  integration
• Safe, effective and efficient processes
• State-of-the-art technology
• Error-free processes that are HIPAA compliant

• Our VISION is to provide an unsurpassed
  scheduling experience for all customers accessing
  WakeMed Health Hospitals.

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VOC TranslationBegin Requirements Flow Down
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Voice of the Customer Survey

• What do you like about WakeMeds current process
  or what do you think is working well?
• What do you think is not working well?
• Please tell us your recommendations on how we can
  improve our process.
• In an ideal world, how would WakeMeds process
  work? Please think about all of WakeMed in
  addition to this specific department.

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Scheduling VOC Survey Feedback

• Easy to post cases and scheduler's able to
  accommodate add-ons and emergency cases
• To schedule a case after 530 is frustrating
• I have to make multiple phone calls to schedule
  different things
• Use of voicemail and returned phone calls takes
  too long

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Scheduling Ideal Process
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Scheduling Recommendations

• Maintain the personal relationship
• Understand consistent negotiables and
  non-negotiables across all scheduling systems
• Maintain appropriate level of backup resources
• Maintain existing contact phone numbers
• Maintain flexibility regarding multiple access
  options
• Provide evolutionary improvement through
  consistent monitoring of metrics
• Create a physical environment conducive to
  collaboration and a shared mission

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Sample Non-Negotiables

• Customer focus human interaction
• Maintaining parallel phone lines for existing
  customers
• Redundancy personnel and system
• Breaking down silos
• Security measures

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Sample Facility Needs

• Adjacent work relationships
• Ergonomically designed workstations
• Sound abatement
• Break room, restrooms, kitchen
• Lighting
• Hospital command center accommodations
• Security

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Sample IT / Telecommunications Needs

• 100 call recording
• System redundancy
• Role/skills-based call routing
• Ability to track volume of calls
• Scripting capabilities

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Sample Performance Metrics

• Schedule request-to-response time
• Customer satisfaction
• Patient sat with scheduling process
• Physicians sat w/ staff competency response
• Retention rate
• New patient volume
• Calls per month

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Methods of Deployment

• Steering Committee
• Management staff meeting updates
• Employee publications
• Physician newsletter
• WakeMed Web
• Shared web site for committee members all
  documents stored here

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Shared Documents Site
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Phase Three In Process

• VP and Transition Team named
• Subcommittees meet monthly
• Continuing to consolidate and improve processes
• Job audits/re-evaluations underway
• Facility design and renovation underway
• Recruiting director
• Developing call flow

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Accomplishments

• Better understanding of functions across
  departments
• Developed system-wide radiology scheduling
  process
• Radiology, surgery scheduling coordination
• Schedulers now pushing to move forward with
  cross-training staff for all services, all
  locations
• Scheduling.com deployment

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Accomplishments

• Tiering of operators jobs to provide after-hours
  support for event, class scheduling
• Consolidation of functions
• Patient placement
• Police dispatch
• Patient Access Center created

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Next Steps

• Complete design of new space
• Relocate into new space
• Continue process improvement, consolidation of
  processes
• Evaluate new services to be offered

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WakeMed Health Hospitals
Raleigh, North Carolina