Intervention Title:
Improving Patient Satisfaction in the Emergency Department (ED) with a Call Back Clerk – Edward Hospital & Health Services; Naperville, Ill.

Goal:
Improve the collection of satisfaction, quality and health improvement data.

Innovation:
Staff developed a dedicated position, the Call Back Clerk, and a user-friendly database to conduct individual patient follow-up calls after discharge from the ED.

Result:
Conducting follow-up calls with patients has helped the hospital consistently achieve 95 percent Press Ganey satisfaction scores, reduce the risk of negative outcomes following discharge, and collect timely and statistically significant patient data.

Institution:
Edward Hospital & Health Services
801 S. Washington
Naperville, IL 60540
P: (630) 527-3000

From the experts:
“Personally following up with discharged patients has had a hugely positive impact on the care that we provide in terms of ensuring patient safety and quality, reducing risk, and measuring overall satisfaction. The personal connection made by the Call Back Clerk is invaluable and helps us ensure that our patients are continuing on to lead healthy and happy lives.”

Tom Scaletta, M.D.
ED Medical Director

Profile:
Edward Hospital & Health Services is a 300-bed acute-care hospitallocated in Naperville, Ill.

Clinical areas affected:

• Emergency department

Staff involved:

• ED leadership
• Information technology (IT) department
• Human resources

Timeline:
After the initial idea was developed and the budget was approved, it took the department about three months to hire, train and fully implement the Call Back Clerk.

Contact:
Tom Scaletta, M.D.
ED Medical Director
P: (630) 527-5025
TScaletta@edward.org

Innovation implementation:
The Edward Hospital ED found that traditionally collected patient satisfaction measurements through Press Ganey scores were good for benchmarking the whole hospital but did not provide timely or statistically significant data at the provider level. The ED staff wanted to continue to improve patient satisfaction by following up with patients and obtaining provider-specific feedback.

In order to conduct individual patient follow-ups, a Call Back Clerk position was created. The Call Back Clerk phones patients discharged from the ED to inquire about the status of their medical conditions and satisfaction with providers. This information is compiled, analyzed for trends and utilized for quality improvement.

The Call Back Clerk only requires a computer with “off-the-shelf” database functions and automatic phone dialing software to manage the process and record the results. The database keeps track of who should be called, and two attempts are made to reach each person. The clerk succeeds in reaching about one-third of patients who are called.

Patients contacted are asked if their condition has changed and are directed to additional medical care as needed. Patients are also asked to rate the physicians and nurses who treated them with a letter grade (A-F). If the grade is lower than an A, the patient is asked why.

Advice and lessons learned:

1. Computers and technology are key, but don't reinvent the wheel. The right technology to manage and automate the Call Back Clerk process is an important part of making this position effective while ensuring that data collected are consistent and can be utilized. However, with that in mind, simple, off-the-shelf software can be easily adapted. It is not necessary to develop a proprietary system.
2. Hire the right staff. The Call Back Clerk position requires a significant amount of patient interaction. Therefore, it is important to hire a staff person who is interested in communicating with people on the telephone for long stretches at a time. Hiring the right person for this task is critical to success.
3. Understand the added value. The information collected by the call backs provides hospitals with a lot of added value beyond simply detailed patient satisfaction data. The Call Back Clerk also obtains information that helps reduce potential liability issues, smoothes transitions in care, and provides valuable feedback to department and individual providers.

Cost/benefit estimate:
The most significant cost for implementing the Call Back Clerk is that of having full-time, dedicated employees to handle the calls. At traditional salary rates, the hospital says this breaks down to approximately $2 per patient. Staffing requirements can be reduced by limiting which patients are called back. Ultimately, the system is seen as paying for itself by improving patient satisfaction, improving quality and reducing risk.

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