Practice Standards

A simple phone call can influence a patient’s decision about whether or not to stay with her doctor, depending on how the receptionist handles it. However, good phone etiquette can be challenging in a practice like the Yale Eye Center, where four receptionists field 3,000 calls a month—booking appointments or, in one case, triaging a call from a woman who’d just been hit in the eye with a tennis ball.

Enter Symposium, the automated phone call distribution system that was first launched in some departments years ago and is currently being fine-tuned throughout the practice. “In the short time I’ve been here, the improvements in call disposition have been tremendous,” said Eileen Giaimo, practice manager for the Yale Eye Center. “Our callers know that they’re going to get Bonnie or Lisa or Sandy, and they are going to be treated well.”

Implementing Symposium throughout Yale Medical Group by 2012 was a directive from the Practice Standards Committee, which meets every second Wednesday of the month at 7:30 a.m. to adopt standards that will take the practice forward, and to discuss ways to measure results once standards are implemented.

Co-chaired by Chief Medical Officer Ronald Vender, MD, and Chief Operating Officer Marianne Dess-Santoro, the committee includes physicians Joshua Copel, Kimberly Davis, Matthew Ellman, Alan Friedman, Peter Herbert, Ian Schwartz, Michael Medvecky, Lynn Tanoue and Lynn Wilson. Staff members on the committee include Kelly Aingworth, Deborah Broadwater, Susan Burhans, Sally Chesney, Marie Follo and Beth Lynch.

Of all of the group’s projects, Dess-Santoro is especially proud of how the Symposium implementation is making the telephone a better customer service tool. “It’s been a huge success,” she said. “Patients are getting to the right person sooner and not having to deal with an endless circle of telephone tag. We’re not sending calls as frequently to the answering service, which used to happen. The script is customizable, but there are standards and branding, so that there is a common thread. Staff managers can listen to phone calls and perform quality assurance reviews, making certain that the words used are correct and as important, that the tone of voice is warm and welcoming.”

Symposium provides standardized metrics for categories such as dropped-call rates and calls per day in real time and historically. Many practices have seen improvements. In plastic surgery, the percentage of dropped calls went from 6 to 2 percent between June 2010 and June 2011, and average wait time went from 39 to 16 seconds.

Sally Thibodeau, director of the central business office and an early leader of the implementation, said the software logic provides practices with options ranging from direct dial to phone tree, or a more popular option known as the phone-tree-in-reverse system. That system accommodates practices that would prefer to have a “live person” answer the phone, yet allows for automated triaging when needed. “I refer to this system as the best of both worlds—no one system is alike. There is a lot of customization,” Thibodeau said.

Now Kelly Ainsworth, project manager, is directing the effort with Claudia Meyers, who joined YMG in January as patient access coordinator, to contact various practices and narrow down the phone lines. For pediatrics, which has many doctors and multiple locations, that meant designing a small-scale call center. “There are some departments that really need that because of the volume and the traffic they get. Other offices, like genetics, may have one person answering the phone and really, really need to be hands-on with the patients. We want to do the best thing for each patient population.”

Meyers starts each implementation process by gathering information about how many locations a practice has and how many calls it gets. “Then we sit down and talk about their wish list. We design a flow chart, massaging it back and forth,” she said.

Giaimo sees the human side of the new system’s impact when she uses it to listen to calls taken by receptionists for the Yale Eye Center’s 15 providers, from patients who sometimes have urgent questions about post-operative problems or medications.“

“We have a monthly meeting where we sit down and look at the statistics—what the volumes are, how many dropped calls we had, and what our hold times were. We go through those monthly numbers and identify where we can find areas to improve. When I’m with the whole staff, I’ll play calls live to demonstrate those needing improvement. We discuss ways they could have been handled differently, and what we could have said to fill the dead air time and resolve questions more efficiently.”

“It’s been very effective for us,” Giaimo said. “Knowing that there are statistics and knowing that somebody is listening is really making all of us more conscious of how we’re using the phone to provide service to our patients.”