Overview
Patients get frustrated if they have trouble reaching their practice by phone or getting responses to secure email. Making your telephone and email systems patient-friendly is an important aspect of addressing health literacy. Some patients will hang up if the telephone system is confusing or it takes them too long to reach a person. Efficient and courteous call and email management may save your practice time and money and will benefit your patients as well.
Actions
Assess your telephone system.
- Use a "mystery shopper." Have someone in your practice act as if they were a patient, both during and after business hours. Use the Telephone Assessment Guide to determine whether patients have difficulty.
- Ask patients about the phone system. Refer to suggestions in the Track Your Progress section below.
Improve your telephone system.
- If you have an automated system:
- Offer choices in the languages commonly spoken by your patients.
- Always have an option to speak to a person. Some patients are intimidated by automated systems or like talking to a person instead of a machine.
- Create a menu with no more than five choices. Refer to Sample Automated Telephone System Menu for a set of options and a flow chart.
- Set policies for responding to phone calls:
- How quickly phones should be answered (e.g., within three rings).
- What to do when speakers of languages other than English call.
- Checking back with people placed on hold after a set period (e.g., after 1 minute).
- Transferring calls (e.g., avoid asking patients to dial another number), including plans for what to do if the other party does not pick up the call.
- Always offering to transfer to voicemail or take a message.
- Have a schedule to ensure phones are covered throughout office hours. If your office closes for lunch, have a message stating the hours you are closed.
- Create an after-hours message or have a phone service cover the phones during non-business hours. After-hours messages should include instructions to call 911 in case of an emergency and a phone number to reach the clinician providing coverage. Say the phone number twice, slowly, so patients can write the number down.
Improve how well clinicians and staff communicate on the phone.
- Instill a culture of friendliness and helpfulness. Praise those who are calm, patient, respectful, and responsive. Make sure people know office procedures so they can be problem solvers who are willing to go the extra mile.
- Develop and use written scripts with responses to frequently asked questions to ensure that clear, consistent answers are given. For example, this .
- Use Tool 4: Communicate Clearly to educate staff on best communication practices.
- Encourage staff to use the teach-back method to confirm instructions given over the phone were understood. In addition, phone calls should encourage questions, such as asking, "What questions can I answer for you?"
- Use telephone interpreter services when you do not speak the caller鈥檚 language. (Go to Tool 9: Address Language Differences for more information.)
Choose easy-to-use patient portals.
The recommends choosing a patient portal that is:
- For example, does your portal include an option to see the password as it is typed?
- , such as secure messaging; appointment scheduling; and access to plain language clinical notes, lab results, and after-visit summaries.
- .
Improve secure email exchanges.
- Establish email procedures, such as who will answer which types of messages and how quickly they need to respond.
- Assigning messages that are not clinical to other staff can speed up responses and reduce clinician overload that can contribute to burnout. For more information on email management, refer to the American Medical Association's .
- Keep emails short and simple. Use plain, . Check that your email is responsive to the patient鈥檚 request. Let patients know they can call with questions.
- If you are communicating instructions and need to make sure patients understand, call them and use the teach-back method.
Educate patients about the phone and email systems.
- Distribute a brochure that explains when and how to contact the practice, both during and after office hours. Refer to Welcome Patients: Tool #13 for guidance on developing an easy-to-understand brochure.
- Tell patients how best to communicate with the practice. If a patient needs to contact the practice for something specific鈥攆or example, to talk to a nurse鈥攖ell the patient exactly what they should do.
Track Your Progress
Regularly review the phone system. Do you see fewer problems over time?
Measure expected outcomes of improvements before and after you institute changes (e.g., fewer missed appointments, increased job satisfaction of staff that cover phones).
Regularly monitor how quickly your practice responds to emails.
On a routine basis, ask a sample of patients to provide input on the phone and secure email systems. For example, during a specified week every quarter, have staff ask patients at the end of each call or at check-out if they have had problems with the phone system or have any suggested changes. They could ask:
- "Have you had any trouble reaching the office on the phone lately?"
- "We have changed our phone system recently. Do you find it harder or easier to use than our old system?"
- "Have you used our secure messaging system on the patient portal? What suggestions do you have to improve our responses?"
Before implementing this tool and 2, 6, and 12 months later, collect patient feedback on a selection of questions about this tool from the Health Literacy Patient Feedback Questions.
Refer to Tool 2: Assess Organizational Health Literacy and Create an Improvement Plan to learn how to use data in the improvement process.
