Quality Management Telephone Care

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Quality Manag​​ement Telephone Care
Randall Sterkel, MD, FAAP

Quality management in telephone care involves providing safe, appropriate and efficient care that meets/exceeds caller expectations. Assessing caller satisfaction is how we know whether or not we are meeting/exceeding expectations.

Minimizing busy signals, hold times and "phone tag," while maximizing human contact are extremely important in securing satisfaction. As Steve Poole wrote: "Few voices can be friendly or helpful enough to the caller who has been on hold for fifteen minutes."

One element of caller satisfaction involves defining and understanding patient expectations. Practices should define telephone policies and procedures to make clear what callers should expect both during and after office hours. This information should include who will call the parent back and how long to expect to wait for a return call (if necessary). These policies should be provided to all new patients and available in all exam rooms.

Practices should identify standards to adhere to regarding telephone care. Examples of customer service standards include number of rings before a call is answered, maximum hold times, maximum call return times, complaint rates and percentage of callers satisfied with their care. Exact numbers to attach to these standards should be determined by each practice.

While many methods for surveying patients exist, it seems most effective to have staff make satisfaction calls during low call-volume periods. Potential questions include:
  1. Was your call answered promptly?
  2. Did the nurse assisting you perform in a courteous and professional manner?
  3. Did the nurse assisting you listen well to your concerns?
  4. Were you satisfied/comfortable with the information provided?
  5. Do you have any comments about the care we provided?​
Additional AAP Telephone Care Resources

Pediatric Telephone Protocols, 15th Edition​
A go-to resource for telephone care triage, which covers a broad spectrum of caller concerns. 

Pediatric Nurse Telephone Triage
A decision-support tool that is a companion to Pediatric Telephone Protocols, and helps office staff deliver superior telephone advice. 

Breastfeeding Telephone Triage and Advice​​
Resource to help nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers by phone.​​​​​​​

Advertising Disclaimer

Once satisfaction data is generated, these data can be used in a variety of ways to provide quality improvement. This activity can best be accomplished through telephone care meetings with a physician and all telephone care providers in the practice. In these meetings all comments/complaints should be reviewed, trends in service standard numbers (eg. call response times) and caller satisfaction can be followed, and education on patient care issues can occur. If satisfaction data are generated in a provider specific way, this data can also be covered in phone care personnel performance reviews.

Health care provision is increasingly competitive. Much contact with patients/families is by telephone. A great opportunity exists in the assessment and improvement of caller satisfaction in telephone care.

​The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. This content is for informational purposes only. It is not intended to constitute financial or legal advice. A financial advisor or attorney should be consulted if financial or legal advice is desired.

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