Abstract

Aim: To assess the volume of calls, identify the major types of inquiries and implement changes in delivery of care.

Methods: All patient phone calls to the inflammatory bowel disease (IBD) clinic were collected retrospectively for a period of one month (March 2016). These were categorized by types of concern. Based on the analysis of these calls, workflow changes such as informational “biologics packets”, encouragement of use of electronic portal, sub-specialization of the workflow of the nurse coordinators and partnership with specialty pharmacies/infusion center were implemented. Patient calls were collected again for one month (May 2017), to assess impact of the above interventions.

Results: A total of 418 phone calls and 185 phone calls were recorded during February 2016 and May 2017, respectively. Majority of the callers were female, with 61 % of calls in February 2016 and 55% calls in May 2017. Most common diagnosis among the patients was Crohn’s disease; 48% and 43% of the patient callers had this diagnosis in Feb 2016 and May 2017 respectively. A decrease in the number of calls in each grouping category (including those associated with high administrative burden such as inquiries related to scheduling, insurance, medication orders, lab orders and medical records) was noted in May 2017 as compared to February 2016. Asignificant number of calls (37% in March 2016 and 26% in May 2017) did not need direct input from clinical providers.

Conclusion: Evaluation of the patients’ calls to characterize the common reasons and implementing workflow changes based on the analysis can help decrease administrative burden.

Keywords

inflammatory bowel disease clinic, quality improvement, phone call triage, specialty pharmacy, infusion center, IBD, inflammatory bowel disease, ED, emergency department, EMR, electronic medical record, PDSA, plan-do-study-act