The option of working from home is an offering that is commonplace in a variety of industries such as hospitality, banking, retail, and finally – healthcare. Almost one-third American employees work at home – at least part of the time. The discipline of nursing has perfected the remote care of patients over the past decade and is one of the most in-demand clinical service lines in the continuum of care. This article will highlight why and how the “The Trifecta” is beneficial to 1) the patient, 2) the nurses/healthcare workers, and 3) the organization.
If you are feeling skeptical about the cost and logistics, allow me to explain. The implementation and equipment costs are often less than the cost of the real state and boarding expense of an in-house worker. McKesson, the American Healthcare company estimates a savings of $2 million annually since allowing employees to work at home. Training and access to resources including charge nurse support parallels what is available to brick and mortar located staff and for all your operations people- the ability to monitor and supervise the performance and productivity of work at home staff is just as accurate, if not better than the activity in a traditional setting. Here are the winners and the reasons why:
- A sign of an organization that is committed to providing exceptional patient experiences is one that provides their patients access to 24/7 nurse triage services. Market studies indicate today’s consumers want what they want when they want it–including clinical care. Providing patients with the option to speak directly to a triage nurse at any time is now an industry expectation. A high percentage of this work is done by nurses working from home. One of the most established medical call centers in the USA currently has 85% of their nursing team practicing out of their homes. In many cases, the outcome does not involve a trip to the ED. Patients don’t need to leave their homes, drive across town to a network facility or wait in a crowded waiting room for hours waiting to be seen. Telephone Nurse Triage can definitely enrich your patients’ experiences while providing optimal outcomes. Patient satisfaction improves!
- With nurses working from home and when a patient feels the need to talk to a nurse, regardless of the time day has the potential to ensure that once a thorough assessment is performed by the skilled RN and the patient is advised to seek the most appropriate level of care (in the most appropriate setting) and there is no risk for a delay in care. The biggest winner of all is the patient with an improvement in health outcomes.
- Telephone triage is a relatively new specialty of nursing that has evolved over the past 20 years. Being educated in the skill of remotely caring for a patient is a unique opportunity for experienced nurses to expand their clinical knowledge base and fill a gap in the patient’s plan of care. The prospect of working as a nurse from the comfort of home is intriguing to many and helps with recruitment efforts. An established outsourced call center reports considerable increase in employee satisfaction scores among work from home staff and a 2017 retention rate of 93%. That translates to a cost savings in new hire onboarding and training. A win-win!
- Roberta RN, started at the call center in late 2016. Within six months she was working from home. “Never in my 23 years of being a nurse did I ever think it would be possible to help patients from my home office. There are so many perks that I never even imagined. My ride into work was at least 45 minutes; I figure I’ve gained about 10 hours a week that I spent in the car and I’m saving at least $50 weekly in gasoline. With the extra time I have in the morning I started walking. I’m up to three miles a day, never felt better, and I lost 33 lbs. I not only care for patients, but I have been able to improve my own health. I love my job.”
- Marcy worked in a busy inner-city Emergency Department for most of her career. Her years of ED experience made her a great candidate for a part-time triage RN position at her organization’s medical call center. “Initially I was very nervous about giving people nursing advice when I couldn’t see them, touch them or be in the same room with them. Luckily, my department had a very detailed training process, and assigned me a preceptor who worked the same schedule as me for my first 90 days. Slowly but surely I began to feel more comfortable and had come to appreciate the impact we were having on patient access. When the opportunity came up for me to work from my home, I was hesitant to apply, but I did go for it. Every written resource, cheat sheet, medication chart, and approved websites that I had at my fingertips and had come to depend on, was available to me at home. I was able to communicate in real time with the other RNs working on my shift as well as my charge nurse. The support was unbelievable. The feeling of being part of a team was something I really needed and something my company made sure was a priority regardless of where you were practicing.”
- Nora, an RN, shared this: “Calls usually take about 10-12 minutes. That is time I am spending 1:1 with that patient; dedicated to their needs and collaborating with them on their plan of care. I came from a very busy med-surg floor where we often had up to six assignments per shift. It got really crazy at times, you were constantly being interrupted, called away from your patient to help with another patient, and having to admit new patients all evening long. Taking care of all the needs of one patient, is ideal and reminds me of my early years as a nurse when we practiced ‘primary nursing’. I live in upper Michigan where winter temperatures drop to sub-zero levels and being able to triage pediatric patients from the warmth of my home, while working in my sweats, and commuting to the basement is a dream come true for a nurse.”
- Samuel Joseph told us, “Of course I am grateful to have the chance to take care of patients over the phone set up in my house, but I am also shocked at the money I am saving. I’m a guy and I guess I must be tough on my work scrubs (and terrible at doing laundry) because I was always spending money on new scrubs when I was working in the hospital. Not anymore! I take a quick shower throw on a pair of jeans and a tee shirt and I’m dressed for work. It’s very cool! I just turned in my leased car and it was the first time ever that I didn’t have to pay for being over the mileage allowed. And one more thing – I used to spend at least $10 a day on coffee, lunches and Diet Cokes I bought whenever I worked. With that savings alone, I have an extra $200 a month. It is an awesome job! “
- No healthcare organization will invest money or allocated resources – especially nurses without a proven contribution to the overarching strategic goals. Whatever the discipline under consideration to work at home, be it clinical or administrative caregivers, one thing for certain – they must at the very least support, if not completely resolve, many of the requirements imposed by the shift to value-based care.
- Nurses working from home promote better patient health, improved population health and a reduction in the cost of care. If one didn’t know better, it would seem that the specialty practice was developed with the Triple Aim in mind.
- Access to clinical care is there when the patients deem it necessary. Work from home staff guarantees that care is provided regardless of the time of day, volume of calls, or hours of operation of the PCP’s clinics. Giving patients more control over their healthcare needs will foster engagement, compliance, and, ultimately, outcomes. Better outcomes result in a cost savings across the continuum of care.
- Remote triage nurses should be proud of the influence they have in the organization’s effort to optimally use all resources. This is most obvious with referrals to the ED. Triage nurses are trained to refer patients away from the ED and towards more appropriate locations of care such as urgent cares, express clinics, or virtual visits. Patients appreciate the collateral benefit of a co-pay savings of hundreds of dollars out of pocket.
The possibility of working from home may sound too good to be true. That may be the case in many professions, but not Telephone Triage Nursing. Patients are better served, nurses love their job and the organization reaps countless benefits. Remote Nursing is truly the Trifecta of healthcare – a Win-Win- Win strategy!
Gina Tabone, MSN, RNC serves as the Vice President of Strategic Clinical Solutions for the TeamHealth Medical Call Center.
Prior to joining TeamHealth, she served as the Administrator of Cleveland Clinic’s NURSE on CALL 24/7 nurse triage program. Under her direction, ED utilization declined, continuous care coordination improved, performance metric targets dropped from 33% ABD to less than 5%, URAC accreditation was achieved, and the call center grew from covering 350 physicians to the integration of more than 1,500 employed and affiliated providers.