Every hospital has clinician hotlines. Not every hospital has hotlines that work well. We know this because clinicians (both GPs and consultants) tell us this a lot and because, since we started providing our telephone Advice & Guidance system around the country, we have brought a number of hotlines onto our platform. When we analyse a hotline using our call tracking data, we find a wide variation in performance.
This matters. If clinicians in your area are able to speak with one another reliably, the results for the healthcare system are profound. As well as helping patients to avoid unnecessary trips to hospital, the links forged between primary and secondary care clinicians benefit everyone. The most common piece of feedback we get from GPs is “it’s good to speak with consultants GPs again”. From consultants it’s “it’s good to speak with GPs again”!
The good news is that you don’t need Consultant Connect to evaluate your hotlines and get them working well, you can do it yourself. Here’s how to go about it.
1. Get the data
The first step is to find out how many calls the hotline is receiving, how many are being answered and who’s calling. If the hotline is a mobile phone, this is easy – most mobiles store this information, which can be recorded weekly or daily according to how many calls the hotline receives. Some calls will have “No Caller ID”, so there will be some gaps in the data, but this is not fatal.
If it’s not a mobile, you’ll have to do a bit more work. As a minimum you should ask the people who receive calls to write a note (including date, time and who’s calling) when they receive a call. If the handset registers missed calls you should record these when they happen.
2. Analyse the data
You need to assess:
- Volume of calls – is the service as well used as you thought?
- Answering rate – what percentage of calls are being answered?
- Who is using it – is the service widely used or just used by a narrow segment of potential users?
This is likely to be when you learn the most about your hotline, and the results you see will probably ask more questions than they answer. For example:
- If the service is not well used, is it because potential users don’t know about it, because calls are not picked up often enough or because there is no need for it?
- If the answering rate is low, why is this? Is an incoming call to the hotline not a priority? Are there adequate staff to answer the calls? Are staff unable to answer for any reason?
- If only a few users are using the hotline, is this because others don’t know that it’s there or why / when it should be used? Is it a useful service?
When you have decided what your questions are, the next step is to…
3. Survey users
We find the best way to carry out surveys is to use a tool like Survey Monkey. You should design one survey for those users who make the calls and another for those answering the calls. Make the survey as short as possible and tell respondents that it’s short!
Our preferred approach is to ask multiple choice questions and allowing respondents to check all that apply. For example, “I have not used the hotline because: a) I do not need the type of advice that it offers; b) I don’t make referrals to that department; c) I didn’t know the hotline existed; d) I don’t have time to call a hotline during the day…”.
This approach does require you to guess at the reasons for the question you are asking, but it does mean that respondents are less likely to skip the question. Including a free text option for “other reason” allows you to pick up answers that you may have missed in your multiple choice options.
4. Act on your findings
Hopefully you now have an idea of what is working well and is not working well with your hotline. Here are some of the actions you might take:
- Work with the departments answering the phones to get answer rates up to an acceptable level (at least 60%). Help them devise rotas so that the phone is covered when the hotline is “on” and, ideally, a backup person who can answer if the other is busy;
- Market the hotline to potential callers. Tell them when the service is available, who will be taking their calls and what they should be using it for. Produce and share case studies that show the positive impact of the hotline;
- Promote usage of the service and discussion amongst colleagues. Bring it up at protected time meetings and encourage users to share their stories, good and bad. Ask for feedback and respond to it, promising action if necessary.
- Supply users with directories of all hotlines and update them regularly.
5. Continue to monitor and improve the service
If the hotline serves a useful purpose and the phone is answered, you should find that usage grows organically. As with all these things, though, you need to continue to monitor performance and check that performance does not drop off as time passes.
A useful canary in the mine is individual user feedback. If you provide an email address for any feedback and it is well known, users will email to let you know if there has been a problem. Often these will be glitches, caused by annual leave or sickness absence resulting in calls going unanswered. If the problem persists, there may be a more substantial, underlying issue that you need to find out about and address. Sometimes the problems you uncover will prompt you to start at step 1 again.
There is also the opportunity to improve the service by, for example, widening the hotline’s scope or extending the hours it is available. One of the most useful improvements can be to start recording outcome data – for example, if a call results in a patient being sent down a better care pathway, that is a powerful piece of data. Keeping records that show that a high percentage of calls achieve that outcome will cement the value of the hotline, both with users and with management at Trusts and Commissioners.
If you would like to discuss the above article or have any comments, please email us at firstname.lastname@example.org or call us on 01865 261467.