Ahead of the curve: PAC wins national awards for improvements to patient access

Since changing its oversight structure and name three years ago, the UI Health Care Patient Access Center (a.k.a., the PAC) is already winning national awards among some stiff competition for they work they do.

At the annual Patient Access Symposium—a national community of almost 80 academic health systems dedicated to improving patient access to health care—the PAC was honored with two awards:

Brenda Byram (left), director of scheduling operations, and Keri Semrau (right), director, receive two awards on behalf of the UI PAC at the Patient Access Symposium in Indianapolis on May 8 to 10, 2018.

2018 Award of Excellence: The PAC won for their impressive outcomes; novel, creative solutions; and for advancing patient quality and safety. Elizabeth W. Woodcock, founder of the Patient Access Symposium, referred to the UI PAC’s “truly incredible infrastructure that they have built” and as “an organization that will propel all of us to be better.”

Best Practice Award for Call Center Management: Given for the PAC’s work in quality assurance, employee retention, leadership development, and new employee orientation. The training team does a two-week onboarding program not matched elsewhere, and the PAC has a leadership development course to groom future leaders. Their quality monitoring and accuracy reporting is also more robust than most institutions.

Keri Semrau, director of the UI PAC, reflected, “I was sitting at the table with some amazing people from Johns Hopkins, Yale, Duke, Wake Forest, etc.—among the greats in academic medicine—and I just thought, ‘Wow.’ UI Health Care rose to the top in practices.”

So what is the Patient Access Center?

The UI Patient Access Center is a contact center that facilitates patient access and scheduling for UI Health Care outpatient services and also offers 24/7 access to nursing triage and the UI Consult, UI Access, and UI children’s phone lines. Every day, the PAC handles approximately 6,150 calls and schedules 2,500 visits.

In addition, other groups within the PAC include:

The PAC has brought scheduling operations from individual departments to a centralized location, standardizing scheduling workflows for most UI Health Care clinics, on and off the main campus. They have since expanded to 118 patient access specialists (schedulers) and well over 150 total staff. In July 2017, the (ICC) Call Center merged with the UI PAC to add 24/7 services and nursing triage to the access center.

How has the PAC improved access to health care?

“We’re change agents, always trying to do things better and more efficiently: transfers, handoffs, triage, etc.,” says Semrau.

Neil Christiansen (center), support services manager in the UI PAC, and Neal Fairchild, lead patient access specialist, meet to collaborate with members of the Surgery Specialty Clinic.

The PAC has implemented automations and other enhancements to improve access to care. Here are some of their major accomplishments:

  • Continued to review process workflows for efficiencies to continue increasing call volumes and appointment scheduling volumes
  • They have optimized the referral intake and triage process using Epic’s referral module. Provider referrals are created in the system for all internal and external referral requests via phone, fax, web, UI CareLink, UI Care Everywhere, and Community Connect Sites. The referral shell triggers insurance verification and authorization workflows prior to scheduling.
  • PAC is working to improve the transition of care from inpatient to outpatient by standardizing and prioritizing inpatient orders scheduling with the goal of ensuring patients leave the hospital with follow-up care scheduled. The outpatient visit scheduling capture rate went from a 60 percent baseline to 85 percent in April 2018.
  • They offer 24/7 scheduling for inpatient discharges for the hospitalist providers and all newborn nursery discharges.
  • They work with key payor groups to keep referrals in network.
  • The PAC-ICC developed and implemented a process in nursing triage algorithms to direct patients to QuickCare and UIeCare when appropriate rather than the Emergency Department. Urgent care will be added when it opens this July.
  • Self-scheduling for return patients is being rolled out to more clinics. No-show rates have decreased as a result of self-scheduling: at 3.07 percent no-show for self-scheduled visits versus a 5.42 percent no-show for visits scheduled by other means.
  • Optimized appointment reminders, an ongoing project that includes interactive text, email, and phone options that allow patients to cancel, confirm, or reschedule. More language options are also available.
  • MyChart FastPass is Epic’s waitlist and has been deployed to the entire organization: 61,622 waitlist offers were sent out for 13,375 encounters, with a 38.9 percent acceptance rate. (Employee perk: UI Choice patients are given waitlist priority.)
  • eCheck-in allows patients to complete check-in, registration, health history, and copays online up to five days before their visit.
  • Working with Patient Financial Services, they eliminated transfers between the two areas and decreased total call time by half.
  • They have regular in-person meetings with each clinic’s staff to build those relationships, review access data, and discuss areas for improved efficiencies.

“We’ve come so far in the last couple years, and we understand there is still a lot of work to be done,” says Semrau. “Focusing on improving departmental relations and confidence in the PAC is our key goal, as well as creating a more transparent practice.”

Members of the UI PAC and Surgery Specialty Clinic meet to review access data and discuss further efficiencies. Seated left to right: Brenda Byram, director of scheduling operations; Trudy Laffoon, MSN, RN-BC; and Jodi Fredericks, support services specialist; background: Ann Tvedte, business manager for the Department of Surgery; and Neil Christiansen, support services manager