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Operations: A Year of Challenge and Innovation

March 11, 2021

YM’s ambulatory operations team responded to the challenges of the COVID-19 pandemic with dedication, innovation, and a commitment to keeping patients safe while meeting their health care needs. At the same time, Operations advanced several initiatives that had been planned before the pandemic struck, including integrating Phase 2 departments into the YM CARE Center and implementing patient self-scheduling through MyChart.

Pandemic Response

In March 2020, as the pandemic began to take hold in Connecticut, the team quickly developed strategies to adapt to new needs. For instance, screening protocols were implemented to ensure patient and staff safety, and highly choreographed workflows were developed for patients presenting with COVID-related symptoms who required an urgent face-to-face visit.

Meanwhile schedulers converted thousands of appointments to video visits when in-person appointments were suspended in April and May. As the use of telehealth continued to grow throughout the year, a virtual support team was established to assist patients and providers with their pre- and post-visit needs, such as check-in and scheduling follow-up appointments and ancillary testing.

When the phased reopening of ambulatory clinics began in June, the ambulatory operations team quickly pivoted once again and redesigned the way those clinics deliver care, minimizing face-to-face contact, limiting patient volume to promote social distancing, and implementing a wide range of other safety measures. With safety as their top priority, the ambulatory clinics gradually worked their way through the backlog of visits and procedures that had been postponed during the spring.

“The YM ambulatory operations team remained on the front line throughout the pandemic, supporting our patients and providers,” said Marie Follo, senior director, ambulatory operations.

In total, Yale Medicine completed 961,165 ambulatory patient visits in 2020, including both in-person and telehealth appointments. While that number represents a 22% drop from 2019 levels, it is stronger than expected in light of the pandemic.

Notably, patient satisfaction (Press Ganey) scores held steady during this time, going from 93.2% in the fourth quarter of 2019 to 93.1% in the fourth quarter of 2020.

YM CARE Center

Despite some pandemic-related revisions to the original schedule, the YM Coordination, Appointment, Referral & Engagement (CARE) Center completed Phase 2 in 2020. With two-thirds of YM departments now integrated, the CARE Center is answering upwards of 6,000 calls per day. The third and final phase, in which the remaining YM departments will transition to the CARE Center, will occur later this year.

Working remotely, CARE Center employees quickly mobilized to meet new challenges, making more than 90,000 calls for COVID appointment conversions in just the first few months of the pandemic, and enrolling nearly 4,000 patients in MyChart during that time. “While it has been exciting to be on the front lines helping patients access the care they need, like other areas, we have had challenges,” said Tina Tolomeo, senior director, patient access. “But our staff and leadership team have risen to the occasion to serve our patients and providers.”

The CARE Center has now been operational for two years, and metrics reinforce that it is making a positive impact. A recent dashboard, which compares a rolling eight-week period to the same period one year ago, shows that referrals are up 22.4%; the average time to schedule is two days; and new patient volume is up 23%.

Patient Self-Scheduling

The launch of patient self-scheduling via MyChart was another notable achievement. Starting in late 2020, patients in in ENT, Neurology (except infusions), Orthopaedics (adult and pediatric), Plastic Surgery, Surgical Oncology, and Urology (adult and pediatric) were given the ability to self-schedule follow-up appointments. Since that time, this option also has been made available to patients in Nephrology, the Diabetes Center, the Bone Center, Digestive Diseases, Rheumatology, and Yale Internal Medicine Associates (YIMA). The self-scheduling option will be rolled out across the entire practice later this year.

Next article: Network Development & Strategy: Telehealth, Clinical Expansion Highlight a Remarkable Year

Submitted by Barbara Steinberger on February 23, 2021