Don't put up roadblocks when callers want info
Correctly handled calls can bring 30% of admits
"I just have a few questions." "I'm calling to get some information." "I don't need an appointment now. I'm just making a call for a family member."
How many times have the receptionists or customer service people in your hospice heard these statements? How many of these inquiries or information-only calls do they turn into new clients?
"Every hospice is missing opportunities for new referrals if these information-only calls are not properly handled," says Polly Rehnwall, president of Polly Rehnwall Inc., a consulting firm in Salt Lake City. When addressed correctly, inquiry calls can represent as high a percentage of admissions as referrals from professional sources, she says.
Not all hospice organizations know how to handle these calls, admits Rehnwall. "My firm offers a 'mystery caller service' to make calls to different hospices to see how the person answering the phone handles the request for information only," she says. "Often we hear the hospice representative say that a doctor's order is needed, the patient must have a terminal illness, and that a brochure can be mailed." None of these responses will help turn a call into an admission, she points out.
When her hospice began treating all calls as potential admissions, there was a significant increase in admissions and referrals, says Terri McEntee, RN, BSN, CHPN, associate director for referral services at Delaware Hospice in Wilmington. "All calls, emergency and information only, are handled the same way by our referral center staff," she explains. Obviously, emergency or professional referrals require a visit by a nurse, but information callers also are offered a visit by a hospice staff member, McEntee says. "We explain that we can easily schedule an information visit at the callers' convenience."
The hospice staff member answering the phones should say, "I'll be happy to give you some help. Tell me why you are calling," suggests Rehnwall. "Then listen patiently in order to build trust." Rather than putting up barriers such as doctor's orders, the staff member can open the door to setting up a visit, she points out.
Information-only visits, as opposed to clinical visits, are scheduled, explains McEntee. Staff members who make the visits don't have to be clinicians, points out McEntee. In fact, a nonclinician often makes the family more comfortable, she adds. Often the caller has very general questions about the services or medical equipment that hospice provides, but some may have specific clinical questions, McEntee says. "If the staff member making the visit cannot answer a question, he or she calls the supervisor and gets the answer before leaving the home," she says.
"Traditional health care people don't always have the attributes needed for a service representative or customer service staff position," Rehnwall says. "Many health care employees are used to following a rule book and working within a highly regulated industry. I've found that people with real estate, sales representative, or even wedding planner experience have made excellent service representatives." The key to finding the right person is to look for someone who is "infinitely curious," she says.
Gather info, paperwork during visit
Paperwork completed during the visit should include information sheets with patient's name, insurance, place of employment, contact information, family member information, and any other information you might normally collect, says Rehnwall.
"Leave all signed paperwork with the family, and explain that this will make the admission process simpler when they are ready," she says.
In addition to information about hospice services, be sure the service representative can talk about all services that might help the caller and the family, suggests Rehnwall. "Meals on Wheels or home health care might be more appropriate services for the family at the time of the visit," she points out. "Your goal is to help the initial caller care for someone in the family, even if it means pointing them to another provider because it is the right thing to do."
Don't be afraid to refer someone to another provider because you already have earned their trust by listening and offering them resources, says Rehnwall. "When the family reaches the point at which hospice is right for the patient, you'll be remembered," she says.
A shift in culture
Creating a successful program to turn inquiries into referrals requires a shift in organizational culture, admits Rehnwall. At first, hospice managers assume that most of their admissions are due to referrals from other providers because they don't get consumer calls, she points out.
"In fact, some of my hospice clients have discovered that 30% of their calls come from family members, not doctors or hospitals," Rehnwall says.
The number of calls coming from family members or friends makes it important to move away from the strictly clinical focus of scheduling patients for admission to hospice, says Rehnwall. "Hospices need to return to their social roots, using chaplains, social workers, volunteers, and nonclinicians who can take on some responsibilities for giving information and support to people who ask for help," she suggests. "Nursing case managers don't have to do it all."
Make sure all staff members throughout the hospice understand the switch to service representatives and giving all callers the same level of service, says Rehnwall. Because you never know who will answer a phone, have a question asked of them in the community, or meet a friend of a patient at the patient's home, all staff members need to know that simple information-only requests can matter significantly to the hospice, she says. "You have to approach every inquiry with the thought that this inquiry is an admission until proven otherwise," Rehnwall says.
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