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Case Study: TeamHealth Medical Call Center Drives Utilization of Appropriate Care for Pediatric Client

The Challenge:

One goal among health care organizations is to appropriate level of care treatment for patients. For a large pediatric TeamHealth client in California, one aspect of consistent care is appropriate level of care when care is needed and to allow their physicians to service those needs whenever possible.

To achieve this goal, the following objectives needed to be met:

  1. Reserve Emergency Department referrals exclusively for patients who require that level of care.
  2. Direct parents/caregivers to follow up with their child’s physician network PCP in cases where waiting until the office re-opens is a clinically viable solution.
  3. Utilize existing client facilities staffed with pediatric resources whenever possible, if imminent care was required after hours.

The Solution:

The client’s after-hours children’s clinic is considered a hybrid urgent care facility with ‘ED-type’ capabilities. The facility is staffed weeknights, weekends and holidays. TeamHealth worked closely with the client to refine referral directives related to specific patient conditions and outcomes and this facility’s ability to deal with more clinically complex cases. TeamHealth met with the client’s business and clinical leaders regularly to review clinical cases and discuss refocusing the ‘post-triage’ process as it related to the appropriate referral of the patient depending on the care needed. These meetings resulted in:

  • The creation of an actively managed “Exceptions List” to the guide the RN’s to refer to the after-hours children’s clinic or defer to another client location, depending on the care needed
  • Refinement of TeamHealth internal system processes
  • Backline communication established between TeamHealth RN’s and client staff in the after-hours children’s clinic for appointment purposes.

The Results:

  • During the next 12 months, 91% of all referred callers were directed to a client facility. The other 9% of referred callers were comprised of parents and caregivers that refused a referral or were undecided (6%), or decided to go to a different non-client facility (3%).
  • The number of ED referrals also dropped significantly.

“We look forward to continuing our partnership with TeamHealth to provide excellent after hours care to our pediatric patient population.”
– Client Manager of Clinical Operation

High Level Detail

Detailed Breakdown

By |June 29, 2016|Case Study|Comments Off on Case Study: TeamHealth Medical Call Center Drives Utilization of Appropriate Care for Pediatric Client

Change is the Only Constant

Change is the Only ConstantIn the year 535 BC, Greek philosopher Heraclitus declared, “The only thing that is constant is change.” For many of us working in the healthcare industry, we wholeheartedly agree that these timeless words continue to ring true, year after year. The word ‘change’ evokes a different response from each of us – but what exactly is change? How is change manifesting itself in today’s healthcare environment and how can we, as leaders, incorporate the implications of change into our organizational cultures?

Webster’s Merriam Dictionary defines change as: 1. To become different; 2. To make (something or someone) different; 3. To become something else. Change is a modification to the process of doing something. In many cases, the modification is made in hopes of creating a better outcome. Often, the expectation of positive change is put on us without tangible evidence to support a better outcome. Today’s healthcare leaders rely on innovators and thought leaders who ‘think out of the box.’ Their role is to introduce variations (changes) to current practices that will ultimately improve patient outcomes, engage their workforce and contribute to the goals of the organization. Identifying and implementing these variations are vital if we hope to improve outcomes. For example, without changes within the healthcare industry, there would never have been advancements in immunizations, birth control and organ transplantation. No change typically means no growth, and no growth is not a sustainable option for any organization.

There are many examples of changes occurring in today’s healthcare environment. The stimuli for most of the modifications are the requisites of the Affordable Healthcare Act. A list must include: healthcare for all, coordination of care, fee for value of care and accountability for outcomes. Programs such as post-discharge call backs, 24/7 access to clinical care, integrated communication via electronic medical records and robust patient satisfaction efforts are all outcomes affected by changes that have evolved in an effort to comply with the new regulations. The collateral benefit is quality, efficiency and exceptional care.

Mention the word ‘change’ to employees, and in many cases, the reaction is predictable. We have all observed rolling eyes, defensive comments, irritation, anxiety and one characteristic response to change – resistance. Change represents the unknown, which can be very intimidating. Those in charge of healthcare organizations need a long-term change management strategy for their organization and the people affected by it—a strategy that encompasses all aspects of the change, from conception through completion.

A leader who is sincere, humble and willing to admit to a level of personal angst when going through changes will have more success with overall buy-in efforts from all levels of an organization. Reminders of past organizational achievements often convince employees to give the ‘change’ a chance. It will hopefully strike a positive chord with front line staff as well, reminding them that they have dealt with change before with positive results. Directly involving those most impacted by the changes is a great way to gain support and alleviate concerns. It is crucial to communicate the fact that the changes occurring are designed to improve patient quality, become more efficient and enhance both the patient AND provider experience.

Change is here to stay; we can count on that. Many of us may not be as open to change, but we can do our best to understand what initiated it and, more importantly, how our role in the process has the potential to influence the accomplishment of organizational goals.

In the famous words of Heraclitus, “The only thing that is constant is change.”

Gina Tabone, MSN, RNCGina Tabone MSN, RNC
Vice President Strategic Clinical Solutions
TeamHealth Medical Call Center

By |June 6, 2016|Blog|Comments Off on Change is the Only Constant