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Posted April 22, 2015

CG CAHPS: Improving Access and Responsiveness to Patients (Part 1)

By Kim Bass

Gaining access to care matters to everyone involved in providing healthcare, including providers, staff and of course, patients. From a clinical perspective, it’s important for patients to receive timely access to care for both safety and quality purposes. There’s also an emotional aspect to accessing care, as patients want to feel valued and connected to their provider.

It’s not uncommon for staff to spend up to six hours of their time answering and responding to phone calls. Subsequently, one of the top questions we receive through coaching of medical practices is how to better manage and/or minimize the volume of phone calls received. It’s important to have systems in place that allow your office to answer patients in a timely and efficient manner.

Patients may be given a CG CAHPS survey after their office visit and there are specific questions about phone calls in the Access composite of the survey:

THE CG CAHPS QUESTIONS:

  • When you phoned this provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?
  • When you made an appointment for a check-up or routine care with this provider, how often did you get an appointment as soon as you needed?
  • When you phoned this provider's office during regular office hours, how often did you get an answer to your medical question that same day?
  • When you phoned this provider's office after regular hours, how often did you get an answer to your medical question as soon as you needed?
  • Wait time includes time spent in the waiting room and exam room. How often did you see this provider within 15 minutes of your appointment time?
In part one of this two-part insight series, we offer tips to improve the efficiency and effectiveness of patient phone calls through call tracking and the use of AIDET®.

Process and Call Tracking

To better understand how to manage calls both effectively and efficiently, we recommend medical practices start by establishing a standardized practice for returning phone calls. First, identify the following:

  • What frequency are phone calls returned during the normal business day?
  • Are your patients informed of an approximate time when they might anticipate a return phone call?
  • Is there a policy in place to ensure phone calls are returned by the close of business each day?
  • If a policy is in place, is it consistent in all of the medical practices?
Try developing a call log to determine trends in the time of day calls are received, the purpose of the calls, how long the calls take, whether the patient’s question is resolved during the first call, is the call transferred, abandoned, placed on hold or sent to voicemail and so on.

It is important to use the information obtained on the call log to determine who is best suited to answer the patient’s questions so that call routing is made easier. Vital information should be gathered so the medical record is in hand when returning the patient’s phone call. If your medical practice uses an electronic health record, a detailed message should be entered so that when the handover occurs, staff returning the call have enough information to reconcile the patient’s inquiry and minimize the amount of time required to do so. (We have an entire chapter, chapter four, dedicated to the importance of answering patient calls, tracking calls and sample call logs in The CG CAHPS Handbook).

AIDET® - Using Key Words at Key Times
We recommend, when possible, that practices set up schedules with a few same-day appointment slots to accommodate patients that want to be seen that day. This demonstrates the practice is committed to patients receiving care in a timely manner. Ensuring that office staff and providers continue to use AIDET® will increase patient understanding and compliance. Specifically, the “A” for Acknowledge, “I” for Introduce, “D” for Duration, and “E” for Explanation can be particularly helpful.

When patients call to make an appointment, front desk staff can begin by using key words and share information through the use of AIDET®. Use of this tactic should begin at the first contact with a patient, when he/she calls to schedule an appointment.

Here’s an example of how Key Words at Key Times/AIDET® can work for a patient calling to schedule an appointment:

  • “Good morning, thank you for calling ABC Family Medicine Clinic, my name is Jenny, how may I assist you today?” (Acknowledge and Introduce)
  • “Mr. Smith, is there a particular day of the week you prefer to schedule or appointment and would you prefer morning or afternoon? Since you would like to be seen today, I’m happy to inform you that Dr. Smith has availability this afternoon at 2 or 2:30 pm. Are you available during either of those times?
  • “I need to get some information for you so we can get your appointment scheduled. This should take approximately five minutes.” (Duration)
  • “Ok, we have you scheduled with Dr. Smith this afternoon at 2:30 pm. Please bring your insurance card and list of any medications that you are taking. It looks like your co-pay for today’s visit is $25.00 – we accept cash, check or any debit/credit card.” (Explanation)
  • “Thank you for calling our practice today. We ask that you arrive 15 minutes prior to your scheduled visit to complete check-in paperwork. We will see you at 2:15.” (Thank You)
AIDET® can and should be used in other phone contacts with patients. For example, here is how a nurse might use AIDET when calling a patient before a procedure:
  • Acknowledge: Always greet the patient by name.
  • Introduce: Introduce yourself by name and your role: “I am Karen and I will be asking you a few questions this morning so we can have all of your paperwork ready when you get here tomorrow.”
  • Duration: “It will take about 10 minutes.”
  • Explanation: “I want to ensure that I capture all of your information correctly so you do not experience any problems with your medical record or your billing process. I also want to run through the schedule for tomorrow and answer any questions you might have.”
  • Thank you: At the close of the interaction, thank the patient for their time, patience, or for having all the necessary information or paperwork at hand.
Stay tuned for part two of this insight that will cover the use of pre-and-post visit phone calls and leveraging the Electronic Health Record (EHR) portal.

Additional Resources:

  • The CG CAHPS Handbook provides tools and tactics to improve patient experiences and clinical outcomes, including improving patient access. Order your copy here.
  • Studer Conferences offer content for every area of the organization. Learn about our Physician Partnership tracks and CG CAHPS content at studergroup.com/conferences.

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Author

  • Kim Bass

    Kim Bass

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