Centralized patient access centers are an important investment for medical groups and health systems as they provide an access point for current and prospective patients. As a means to attract and retain patients, a centralized access center that focuses solely on revenue cycle functions (scheduling, registration, insurance verification and payment collection) may not meet the needs of your patient population and may result in missed opportunities to fully improve patient access and appropriately drive care and service delivery.
Why Do Anything?
Despite the implementation of centralized patient access centers, patients continue to have difficulty obtaining access to urgent or acute care services with their providers. Often times this is due to the non-clinical office personnel’s inability to clinically assess the acuity of the patient complaint or concern. Same day appointments intended to be filled by the more urgent or acutely ill patient are instead filled with patients whose care needs should have been met in an alternate, more appropriate environment. Add in call demand from patients recently discharged from the hospital or outpatient surgery, those with a newly prescribed medication or care regimen, and of course the chronic consumers of health care services. These patient access issues have a secondary effect on the centralized patient access center in the form of higher call volumes and prolonged wait or callback times to find available appointments. As a result there is an overutilization of emergency departments for urgent care and primary care concerns. Not to mention the negative impact on patient satisfaction!
What’s The Answer?
Balance the revenue cycle centric patient access center with Nurse Triage. A centralized nurse triage service line staffed by registered nurses with various areas of expertise (ER, critical care, surgical, pediatric, obstetrics) that are guided using nationally standardized triage and practice specific protocols provide safe and clinically appropriate care advice and service referrals. Telephone nurse practice (TNP) or triage nurses are able to provide medical advice encompassing the treatment of fevers, wound care, and emergent conditions such as chest pain. The nurses are trained to triage conditions to the appropriate level of care at home, with a same day physician appointment, at an urgent care center, or at an emergency department.
What Are The Benefits?
- Already have a centralized patient access center? – the infrastructure is in place just add the clinical components
- Decreases risk of delayed or inappropriate care advice – eliminate non-clinical office personnel giving clinical advice or that “silent” heart attack patient waiting hours for a callback
- Improves physician practice efficiency – clinical staff focused on providing face-to-face services
- Improves after-hour provider utilization – calls to providers require their expertise and level of care
- Improves appropriate utilization of services – physician same day/next day appointments, urgent care center and emergency room utilization
- Facilitates care delivery and coordination through collaboration and exchange of information
- Improves patient satisfaction – patient needs are met in the moment, no wait for callback or extended emergency department wait times
Nurse Triage Comes in Many Shapes and Sizes
When adding Nurse Triage to a centralized patient access center this service line can accommodate more than just symptom based call management. The clinical expertise of a TNP nurse allows for coverage of calls for a variety of reasons: pre-screening for tests and procedures, post-operative/procedure follow-up calls, new medication or treatment compliance calls and calls for complex or chronic case management, to name a few. Nurse Triage can be provided during business hours, 24-hours a day 7 days a week, or somewhere in the middle. Nurse Triage services can be “built” or “bought,” brick and mortar based or deployed remotely, managed 100% within your organization or outsourced to regional or national call centers. Larger medical groups and health systems are likely to use more than one of these approaches to meet the needs of their patient population and providers.
Does Your Centralized Patient Access Center Set The Bar?
Centralized patient access centers that include Nurse Triage allow medical group and hospital based staff to focus on the face-to-face patient interactions. Investing in a service line that ensures patient care needs are being met at the appropriate level of care by the appropriately licensed professional improve operational efficiencies, decrease risk to the patient and the organization, increase patient satisfaction, and improve patient outcomes. Does your centralized patient access center provide appropriate and safe clinical advice, prevent unnecessary readmissions, empower patients in self-care, ensure appropriate ED utilization, and initiate referrals to care providers and services within your organization?