Next Step in Care: Family Caregivers & Health Care Professionals Working Together

Multiple Calls from Multiple Places May Cause Coordination Challenges


This article was originally published in the September 2015 issue of Healthcare Call Center Times and is posted here with permission.

Multiple Calls from Multiple Places May Cause Coordination Challenges

NEW YORK, NY—On Tuesday, April 14, The New York Times carried a story in its Science Times section, "They're All Just Trying to Help" that discussed the variety of phone calls that may await patients once they are discharged from the hospital. The calls may be coming from different organizations and often are not coordinated together. The goal is always helpful; the result, however, can be confusion on the patient end.

One of the people interviewed by the NY Times for this story was Carol Levine, director of the United Hospital Fund's Families and Health Care Project. We reached out to her to get her view on how this profusion of care coordination calls can affect the work that hospital/health system call centers do in this arena.

First of all, Levine acknowledges that it is really important to follow up with patients after discharge but what often happens is in line with a health system that is fragmented and siloed. "All of these callers are calling within their own silo and no one explains to patients that several people may be calling," she says.

For example, there may be multiple calls from various parts of the hospital that are looking at issues that include: risk management, patient satisfaction and clinical compliance with discharge instructions. Those calls can originate from the call center or other parts of the organization. Additionally, if the patient is part of a research protocol there can be calls from that team. Then there's the health plan, which may call and ask questions that have already been asked by the hospital call center.

How do we sort all this out and what does this mean for the call center? First of all, she says that hospitals need to do a better job preparing patients for what happens after discharge. "Patients need to be told that they may be getting one or more calls so you don't blindside them," Levine says. "Many people are nervous about getting calls from strangers."

To make patients at ease she recommends that the caller (whether it comes from the hospital call center, the health plan or another interested entity) create a human bond right from the start rather than launching immediately into what may seem to the patient as a perfunctory series of questions. One way to start is to acknowledge that you understand that the person has just come back from the hospital and that this may be a difficult time for them. The goal is to establish "that there's a person who cares about you," she says.

If this is a post-discharge call that has already been done by another organization the patient may wonder why they have to answer all these questions again. Levine says that it's important to explain that these are different organizations that have a need to collect and understand this information—all for the benefit of the patient. The repetitive nature of the questions needs to be acknowledged and then a goal of brevity stated.

In some cases, patients may report that the information the call center representative is telling them is not consistent either with what they understood when they were released from the hospital or in line with another entity that has made a discharge call to them. For the call center representative receiving this feedback from the patient, the proper response is not to simply overrule the other instructions or information and insist you are right. Rather, Levine says, the best way to handle this is to tell the patient that you will look into it and get back to them. The patient may be in error or the other entity may be wrong, but the resolution should all be completed away from the patient. Then, when the patient is called back, it will be with the assurance that everyone is on the same page.

It isn't just hospitals, physicians and health plans that may be contacting the patient after discharge. It can also be others involved in the healthcare continuum, which can include such players as adult day care and meals on wheels. To keep track of all this, Levine's organization has prepared a Family Caregiver's Guide to Care Coordination. This explains the role of the care coordinator and suggests that notes be kept each time that a care coordination interaction happens so it is down in writing what was said.

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