URAC AccreditedBy Wendy Smith

As an outsourced medical call center to healthcare providers across the nation, quality service delivery is our mission. It is of utmost importance to our clients, crucial to the integrity of a clinical service and directly impacts a patient’s confidence in their provider.

Top notch service delivery though is not possible without a strong Quality Improvement (QI) program. We love discussing QI because it is point of pride for us. Successful call centers actively monitor performance metrics both to drive quality and to measure the effectiveness of service, and we have a very active and goal oriented QI directive.

Different QI monitors have different weights within an organization depending on the services that are being delivered. It is important for healthcare providers looking to outsource call center services to familiarize themselves with the facets of QI that are pertinent to their business model and customer demographic.

At our medical call center, we QI three core groups of activities: Accessibility of Services; Member / Client Satisfaction; Clinical Practice; and Communication and Documentation. Through these core QI groups we get a solid reading on how well our call center is performing our mission of impeccable service delivery.

Accessibility of Services consists of several sets of monitors that we do on a continuing basis to ensure that our services are available to our clients when needed. They include how quickly we live answer the phone; the hang up time and rate; whether a busy signal is ever heard; the time it takes for a nurse call back if the call is not urgent in nature; IT efficiency; and disaster/business continuity testing. We have set goals or thresholds for each of these monitors and we report on them on a regular basis to our clients and to the quality committee.

Member / Client Satisfaction programs maintain a routine of surveying callers and clients to make sure they are satisfied with our services. Callers are surveyed quarterly and clients are surveyed annually. This information is taken to the quality committee and executive committee.

Clinical Practice measures all aspects of our clinical services including the aggregate disposition of triage calls, clinical to triage call ratio, prescription medications, and how urgent calls are handled. Other types of calls such as pediatric asthma may be reviewed on an individual basis as well.

Communication and Documentation is monitored for appropriateness using different tools such as silent monitoring of the call recordings and documentation of the written report. Both nurses and non-clinical representatives are monitored for accuracy and appropriateness.

These metrics give us the tools to meet and exceed the needs and strategic goals of our clients. For example, new clients without existing call center services might not know what monitors are important to their patients. Through the discovery and implementation process, we determine the things that are most relevant to a client’s needs and that will provide solid data to measure their progress. Or a client may already have an in-house call center and wants to add services. This client already has a level of excellence that they want to meet and/or exceed. Or perhaps a client has had a bad experience with another call center and needs to improve quality and mend relationships with patients. We can set directives, measure improvement and help this client meet their desired level of service and / or regain the confidence of their patients and clientele.

Our QI program tells us where we’re excelling and where we need improvement. It gives us documented proof that we are meeting our goals and those of our clients. Quality service delivery is our mission and our solid Qi program paves that road.


Wendy Smith

Wendy Smith