Emergency departments (ED) in the United States began around 1880 as accident services provided through a workman’s compensation plan. Today, it’s common for healthcare organizations to have an ED within their hospital building, with dedicated staff, that offers critical and indispensable care to approximately 139 million Americans who go to the emergency room each year.
Typically, patients can visit the ED with any complaint, so medical staff need to prioritize cases based on clinical need using a process called triage. Triage is a brief assessment of the patient’s condition usually done in-person by a triage nurse.
Even though most patients continue to receive care in the ED or are passed to another area of the hospital after triage, estimates show that approximately 32 percent of visits to EDs are non-urgent and can be treated during triage or in other care settings.
Telephone Triage Nurses
The use of nurse on-call hotlines and telephone triage nurses (TTNs) are provided by some healthcare systems as part of their telehealth services. Patients who are unsure if their medical need is urgent enough for an emergency room visit can speak to a registered nurse on the phone. The TTN asks a series of questions to quickly asses the caller’s condition and give advice for minor complaints or recommend an ED visit for more serious concerns.
Nurses who work as contact center agents are part of a hospital’s comprehensive response to emergencies. Services are provided 24 hours a day, 7 days a week – just like a brick and mortar emergency department. Patients experience the additional convenience of receiving care remotely without having to travel.
In a study published in 2017, researchers at the University of Maryland School of Medicine (UMSOM) found that an average of 47.7 percent of all medical care in the United States was delivered by EDs. Helping non-critical patients in the comfort of their own homes also means more time can be dedicated to those who are experiencing an actual emergency.
COVID-19’s Impact on Hospitals
When the coronavirus pandemic began in early 2020, emergency departments in the United States experienced a six percent increase in patient visits. Some hospitals asked for support from their call center operators who were able to help relieve the burden of short-staffed departments by assisting patients with insurance, registration, and other services over the phone.
As the virus spread, the Centers for Medicare & Medicaid Services (CMS) asked EDs to screen patients for COVID-19 in an effort to keep patients and medical staff safe. Many people became afraid to go to the emergency room despite the assurances of safety from healthcare organizations, resulting in a decreased in visits to the ED by more than 30 percent in April 2020.
Hospital’s began to postpone elective surgeries to free up space and supplies for treatment of COVID-19 patients. Various departments experienced a drastic decrease in patient visits and some hospital systems began to layoff staff.
Healthcare organizations were able to leverage their contact centers and train staff members, who would otherwise have been laid-off, to answer the ever-increasing calls to their call centers. “We were able to redistribute existing staff from other departments and tap into their skills to cross-train them to work for the switchboard. In our situation, patient access staff and medical answer teams were trained on easy calls and were then able to work from home as remote operators. These staff members are now even more valuable to our organization,” said Shelley White, Director of Patient Access Services for State University of New York (SUNY) Upstate Medical University.
COVID-19’s Impact on Hospital Contact Centers
“We are experiencing extremely high call volume related to COVID-19 information and vaccine interest. Please understand that our phone lines must be clear for urgent medical care needs. We are unable to accept phone calls to schedule COVID-19 vaccinations at this time.” Messages similar to this one are appearing in banners at the top of many hospital websites.
Call volume related to COVID-19 information has been overwhelming. The Federal Emergency Management Agency (FEMA) advises to, “Establish a coordinated call center system to divert non-emergency calls from a community’s 9-1-1 system, and non-critically ill patients away from the emergency healthcare system. A coordinated call center system allows multiple agencies and organizations to share the high load of calls during a pandemic by integrating components of those organizations such as call centers, information lines, and crisis centers.”
Hospital contact centers help in this endeavor by establishing hotlines in their region. Jennie McWhorter, IS Operations Manager for Ephraim McDowell Health in Danville, KY said, “Our call center agents are also the hub of our COVID-19 hotline. The community can dial the number they already know and get the updated information they need through our 24/7 operators.”
Healthcare call centers continue to use technology in new ways and pivot when needed to assist patients and try to ease the strain on hospital emergency departments. Shelley White stated, “Our call center software has given us so much flexibility to keep up with this ever-changing COVID-19 crisis. We are able to smooth workflow peaks and valleys and went from being overwhelmed with calls at the beginning of this situation, to having improved call metrics.”