The Ten Critical Steps of Taking a Triage Call



By Marci Lawing

The goal of every triage call is to make patients feel comfortable and heard, while at the same time collect critical information from them and get them to the appropriate level of care based on their symptoms.

Step 1: Introduce Yourself. Use your first name, title, and the practice or physician you represent. It’s imperative for you to clearly identify yourself and state your credentials as a nurse employee of the practice for which you work. When you introduce yourself, you create a relationship.

Step 2: Collect Demographic Information. Before you are ready to hear your patient’s concerns, you will need to know some basic information. Age, gender, and other data will affect your triage protocols, so be sure to collect all the necessary demographic information. This information is needed so it can be put in the appropriate chart and followed up.

Step 3: Gather Medical History. Get a brief medical history so you do not miss any important surgeries, medications, or relevant medical information from the recent months or years. You’ll want to know your patient’s medical history before he or she details the current issue.

Step 4: Let the Patient Talk. Now that you’ve armed yourself with all the necessary information you need to proceed, let the patient speak freely about current concerns. Be an active listener. That means that you don’t just listen; you participate in the conversation by asking any probing questions needed to ascertain a full description of the patient’s complaint.

Step 5: Document the Assessment. Once you’ve listened carefully to the patient, document your assessment carefully with the necessary details.

Step 6: Choose the Right Protocol. With the right triage protocol, this step can be fast and efficient. Be sure to document the answer to each question and make any additional notes needed.

Step 7: Get the Patient to the Right Level of Care. Now that you’ve followed the protocols and completed the assessment, you’re ready to recommend the level of care your patient needs. Be sure to speak clearly and at a pace the patient can follow while you detail every step he or she needs to take.

Step 8: Give Relevant Care Advice. Provide solutions based on the patient’s symptoms in order to help identify the best path to care.

Step 9: Make Sure Your Patient Knows When to Call Back. Confirm that the patient fully understands your triage advice and knows when and who to follow up with.

Step 10: Offer Reassurance. Make sure your patient is able and willing to follow the plan you discussed. It is important, especially with serious symptoms, that the patient follows your triage advice. If told to go to the ER, verify with the patient that he or she has access to safe transportation.

You can’t underestimate the power of empathy. Over 80 percent of patients who call their physician’s office may not need urgent care, but they all urgently need empathy, someone to listen, and someone to care. That’s the role of the triage nurse. In addition to being a good clinician, a critical thinker, and making sure everyone stays safe, you are also there to provide empathy and care advice to patients.

These ten critical steps will help you stay on track and ensure that patients get the quality care they deserve.

Marci Lawing, RN BSN, is the clinical nurse manager at TriageLogic LLC. TriageLogic’s online learning center is available free of charge to telephone triage nurses and teams as an educational resource and practical training guide. Along with course videos, coursework includes class notes, related articles, and learning materials. You will receive a TriageLogic Telephone Nurse Triage Certification for each completed course. Managers can also set up teams and check their individual nurses’ progress in the course.

The Patient Experience Contact Center



By Richard D. Stier

Patient experience failure, the incentivized reduction of avoidable readmissions, increasing rates of physician burnout, and the escalating priority of revenue cycle management, have all combined to incubate an unexpected solution: Exit the call center; discontinue generic transactions.

Instead the patient experience contact center is born. Enter the era of thoughtfully deployed patient experiences, beginning with the first point of contact. In contrast to yesterday’s call centers, which processed physician referrals and class enrollments, today’s patient experience contact centers are a health network’s communications nerve center. They deliver intentionally memorable experiences that strengthen preferences, mitigate risk, reduce unnecessary readmissions, serve as physician practice extenders, and solidify patient loyalty.

Patient Experience Failure: Currently healthcare has a 29 percent patient experience failure rate, according to research by Hospital Compare. Only 71 percent of inpatient patients receiving care report that they received the “Best Possible Care.”

In what universe is a 29 percent failure rate acceptable? Could we miss revenue projections by 29 percent? Be over budget by 29 percent? Would it ever be acceptable to miss quality standards by 29 percent? “We only dropped 29 percent of newborns, so we met the standard.” Seriously?

“Best Possible Care” experiences begin before a patient receives care and continues after the patient returns home. Healthcare contact centers are uniquely positioned. They serve as the virtual front door for personalized support and referrals before using a clinical service and for individualized follow-up and coaching after discharge.

With the launch of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program by CMS in 2006, hospitals have dedicated significant time and resources to improving the results of CAHPS surveys. The shift from a transaction-focused call center to an experience-driven contact center is an investment to improve the experience of care—beginning with the first touchpoint when someone new to the community calls to request a referral to a primary care physician (PCP) and continuing after discharge when a contact center navigator calls to confirm a follow-up visit with that PCP.

That first touchpoint is critical. According to SHSMD (2012), the first three seconds of that initial interaction influences hospital selection and preference. Whether on the phone or online, healthcare contact centers can intentionally deliver a transformative first patient experience.

Incentivized Reduction of Avoidable Readmissions: One-half of all hospitals in the United States (2,597) will be penalized by the Centers for Medicare & Medicaid Services (CMS) for unnecessary readmissions in FY 2017. Those penalties will total $528 million, over $100 million more than in FY 2016. During 2016 forty-nine hospitals received the maximum penalty of 3 percent withholding from Medicare funding. A total of 1,621 hospitals have been fined over each of the five years (source: HealthStream SUMMIT 2016).

Preventable readmissions represent a substantial portion of unnecessary medical spending. According to data from the Center for Health Information and Analysis (CHIA), the estimated annual cost of this problem for Medicare is $26 billion annually, $17 billion of which is considered avoidable (source: Provider Advisor 2016 Volume 2, Issue 2, p. 4).

It’s about to get even harder. For FY 2017, CMS is adding open-heart surgery—a more complex, longer-stay procedure—to the list of clinical conditions monitored for avoidable readmissions.

Increasing Physician Burnout: Nine out of ten physicians discourage others from joining the profession. Currently about 300 physicians commit suicide every year (source: Daniela Drake, The Daily Beast, 2014).

As many as one in three physicians is suffering from burnout, which is linked to a list of pervasively negative consequences, including lower patient satisfaction and care quality, higher medical error rates, greater malpractice risk, higher physician turnover, physician alcohol and drug abuse and addiction, and physician suicide (source: Dike Drummond, MD, Stop Physician Burnout).

Physicians face increasing burdens, including the complexities of ICD-10 coding; new billing models; responding to new government regulations; dealing with a changing landscape of health plans; sharing information across the network; inefficiencies of credentialing, provider enrollment, and onboarding; documenting quality; cybersecurity; loss of autonomy; threats from alternative providers; and the “retailization” of primary care.

And, here comes the value-based reimbursement plan for physicians: MACRA (Medicare Access and CHIP Reauthorization Act). Beginning in 2019 physicians will be reimbursed on various performance metrics such as quality, advancing care quality, resource use, and clinical practice improvement. According to Deloitte, “Providers are in for a notable awakening when the law takes place in 2017.”

On top of this avalanche of stressors, physicians must keep up-to-date clinically, build practice volume, and improve their patients’ experiences. Are you exhausted yet?

Growing Focus on Revenue Cycle Management: The Affordable Care Act (ACA) and Medicaid expansion has created an influx of previously uninsured patients that has left healthcare organizations scrambling to accommodate increased demand while simultaneously experiencing lower margins. Because consumers are assuming greater financial responsibility for their own healthcare, healthcare delivery networks must shift from a wholesale to a retail environment where they interact directly with patients on issues such as pricing, billing, and payment. Unfortunately, hospitals and health networks are experiencing a strong correlation between the use of high-deductible plans and the amount of bad debt they are incurring (source: HealthCare Finance, 2016).

Concurrently, few healthcare organizations have taken the steps necessary to integrate the many information systems that support revenue cycle management. Systems are incompatible across service lines, locations, and functionality. Different software solutions are frequently employed to support disparate functions such as registration, clinical documentation, and billing.

Even worse, some of these functions may be done manually or are only partially automated, making data analysis incomplete or impossible. As the industry migrates toward value-based care, healthcare organizations are entering new collaborations, taking on risk contracts, exploring alternative sources of revenue, and being pressured to document outcomes.

Summary: Patient experience contact centers are a timely response to a myriad of industry pressures. Redeploying a legacy transaction-focused call center as a patient experience contact center can strengthen preference for your organization, mitigate risk, reduce unnecessary readmissions, serve as a physician practice extender, and solidify patient loyalty.

Richard D. Stier, MBA, is vice president of marketing for Echo, a HealthStream Company. He is a passionate and results-proven proponent of delivering transformative patient experiences.

Moving from “Sick Care” to “Health Care”



By Mark Dwyer

In 2012 our government enacted legislature that mandated U.S. hospitals to reduce readmissions by emergency departments (ED) admits for the first thirty days post-discharge. To force this change in behavior rather than wait for hospitals to choose to proactively address the overall health of their communities, the government began penalizing hospitals who had higher than average readmission rates through a deduction in their reimbursed Medicare payments.

This was a radical change in American healthcare; it put the onus of keeping patients well on the hospitals and providers who treated them. No longer could hospitals simply wait for individuals to require hospital care; instead it became their responsibility to proactively manage ED-admitted patients for at least the first thirty days post-discharge. If they were unsuccessful in providing the patient with the tools and help needed to keep them from readmitting, they bore the weight of a financial penalty.

Initially, the penalty amounted to 1 percent of the hospital’s total annual Medicare reimbursement. It was tied to three specific DRGs (diagnosis related groups): acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Each hospital was scored against its neighboring hospitals to determine which ones had readmission rates in the highest twenty-fifth percentile of the surrounding hospitals. If a patient who had been admitted via the ED due to one of these three DRGs required readmission within thirty days post-discharge, and the hospital’s readmission rate was in the highest twenty-fifth percentile of hospitals in the area, the hospital’s overall annual Medicare reimbursement was reduced by 1 percent. Although 1 percent may not seem like a lot, when applied against the hospital’s entire Medicare reimbursement dollars, it was significant—especially for hospitals operating with only 2 to 3 percent profit margins.

But the government didn’t stop there. In year two of the program, the percentage of Medicare reduction was increased to 2 percent of the hospital’s total annual Medicare reimbursement amount. In year three, not only was the percentage again increased to 3 percent of the hospital’s overall Medicare reimbursement, but three additional DRGs were added: elective knee replacement, elective hip replacement, and chronic obstructive pulmonary disease (COPD).

At this point many hospitals began paying attention, especially when over 2,200 U.S. hospitals were penalized for failing to reduce their readmission rates. To address this ever-increasing reimbursement reduction, hospitals had to implement programs to manage Medicare patients post-discharge for at least the first thirty days. To do so, many homegrown programs were introduced with varying success.

A number of healthcare software vendors began developing and marketing programs to help educate and manage the patients post-discharge. Some of these programs involved on-site care management visits, phone calls, reminder texts, and emails. Some also involved extensive motivational programs designed to not only assist patients in remaining proactive about their care but also the patient’s caregiver. Too often the Medicare patient’s primary caregiver is an elderly spouse who is also battling a litany of health issues. Assisting them and other familial caregivers was determined to play a critical role in the process.

But what about the many patients who suffer from more than one chronic disease? Some vendors realized that many Medicare patients suffer from comorbidities. It is not unlikely for an individual with diabetes to also be obese, or someone with HF to have been admitted with an AMI DRG. Initially, since these various disease states were defined as separate care plans, patients suffering from comorbidities experienced multiple interactions post-discharge in order to manage all conditions that could possibly result in a costly readmission.

To motivate patients and their caregivers to follow post-discharge instructions regarding medications, to make and attend post-discharge provider appointments, and to integrate with the hospital’s care management or medical call centers, vendors have begun collaborating with leading content developers. By adding patient educational and motivational training content to their software programs, post-discharge programs can enable nurses or care coordinators conducting follow-up calls to select the specific information needed to address each patient’s multiple issues. This comorbidity program approach eliminates the need for redundant calls to address each of the patient’s healthcare issues. Instead it enables the nurse or care coordinator to select the content, surveys, motivational scripts, and other resources needed to meet all of the patient’s unique needs across a wide array of health conditions.

Future-thinking hospitals and providers who see the need for follow-up beyond the initial thirty days post-discharge are beginning to take a stand for long-term health management by using customizable comorbidity programs. This is a real step in the direction of healthcare management. Imagine a future where healthcare generates greater revenues from having empty beds, keeping area residents healthy and at home.

Mark Dwyer is the COO of LVM Systems, Inc. For more information about LVM’s Comorbidity Care Management Program (CCMP), contact LVM Systems sales at 480-633-8200 x223 or info@lvmsystems.com.

Interoperability in the Healthcare Call Center


Amtelco


By Matt Everly

The call center in a healthcare organization preforms a variety of important functions. One is serving as a virtual lobby when processing internal and external calls. It may be the initial touchpoint a patient has with the organization, so the experience must be positive. As the saying goes, “You only have one opportunity to make a first impression.” The call center also serves as the nerve center for ongoing communications.

Modern healthcare call centers need to handle all types of calls quickly and efficiently. To ensure that the virtual lobby experience is positive, the call center agents need immediate access to accurate data. To accomplish this, information systems need to share, pass, and store usable data from system to system. Interoperability is a term used in healthcare to describe the idea of different technologies and systems communicating to share data.

To handle calls effectively, the call center system needs to use data that may reside in external databases on other systems. As an example, if a caller wants to talk to an admitted patient, the agent needs to know which room to send the call to. Most patient admission, discharge, and transfer (ADT) information resides in a database that is external to the call center system.

Without interoperability, the agent would have to bring up a second screen to view the ADT information, go back to the call center system screen, manually enter the room extension, and transfer the call. With interoperability, the call center system can automatically download the ADT information from the external database and present it to the agent on the call center screen, thus eliminating several steps and decreasing the chance of error. Interoperability works behind the scenes to automate data exchanges and sharing.

Making sure the hospital call center is interoperable with other systems is the safe way to make sure call center agents communicate with callers in a timely and effective manner. A few of the important IT systems and technologies that should be interoperable within the healthcare call center system include:

  • Electronic health records (EHR)
  • Messaging applications (paging and secure messaging apps)
  • Alarms and monitoring systems
  • Nurse call systems
  • Scheduling systems

Many healthcare call centers routinely use outdated technology. Binders with paper call schedules, non-PC-based PBX consoles, fax machines, data access terminals, and sticky notes are used by agents to access the information they need to handle calls. These makeshift solutions lead to inefficiency and mistakes.

Interoperability Works Both Ways: Hospital call center systems store information as administrators and agents input data or create schedules. This information may be valuable to other departments or used to augment an external document.

As an example, when an agent takes a message from a patient for a clinician, that message can be automatically sent to the EHR system and be posted to that patient’s individual electronic health record. By using interoperability, information from numerous databases can be combined in one area to form a master record for a particular patient.

Not All Systems Allow Interoperability: Legacy systems and technologies were not designed with data exchange in mind. There are several ways to connect IT systems to the healthcare organization’s larger digital ecosystem, but these can be costly and potentially unreliable.

Health Level Seven (HL7) is a set of standards used to transfer clinical and administrative data between software applications. Many present-day IT developers design products with HL7 in mind, helping organizations move toward interoperability throughout the enterprise. The healthcare call center can use HL7 to populate patient, clinician, and employee directories for agents. HL7 also can be used as a way to post information from the call center system to a patient’s EHR.

Reducing Costs: Interoperability will make your call center agents more efficient, eliminate mistakes, and reduce costs by automating processes that are currently handled manually. As healthcare providers look to reduce expenses, interoperability in the call center is a natural solution.

Matt Everly is the marketing director for Amtelco’s 1Call healthcare division. Matt has worked at Amtelco for over twenty years and has held numerous positions, including southeast regional sales manager, executive suite market development, and marketing manager.

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Medical Call Centers Rise to Meet Healthcare’s Pressing Needs



By Gina Tabone

Medical call centers have finally gained recognition and credibility in the healthcare marketplace. Centralized medical call centers are rapidly emerging as the backbone of health systems because they are integral in achieving better patient outcomes. They offer a proven solution for reaching the three goals of the triple aim: improving the patient experience of care, improving population health, and reducing the per capita cost of healthcare.

Improving patient experience requires open access so patients receive the most appropriate level of care needed, in a time best determined by specially trained nurses guided by evidence-based tools. The patient learns to expect reliable advice, taking into account their current health state and consistently available day or night. Gaps in care are eliminated and delays are avoided, leading to favorable patient outcomes and higher reimbursements in a fee-for-value model. When patients’ well-being is enhanced, everyone gains, especially the patients. Medical call centers can stake a claim for making that happen.

Labor costs consume up to 70 percent of many call centers’ operating budgets. Outside partners can assume the responsibilities with greater efficiency and better outcomes for a lower cost. The choice to retain, outsource, or develop a hybrid pursuit is a multifaceted decision that organizations must thoroughly evaluate to determine which solution best aligns with their mission, future vision, and strategic plans.

Medical call centers are taking on a variety of responsibilities that are well suited to be conducted remotely and reliant on state-of-the-art technology and a dedicated workforce. Appointment scheduling is the most common task in many medical call centers and often happens in tandem with the strategy of centralization. Electronic medical records (EMR) products now have customized templates embedded with providers’ schedules used for office visits, imaging, or procedural appointments. Outbound calling campaigns are often conducted in conjunction with scheduling for appointment reminders.

Additionally, centralizing medication refill requests is emerging as a successful addition to many medical call centers. Call center technology such as CRM (customer relationship management) allows requests to be tracked, acted upon, and measured to ensure that established targets are met in a timely manner. Patients expect a standard process for their medication needs and a defined time for responses or resolution. Medication management and compliance is critical for optimal outcomes, so implementing a process that fosters this is a good idea. Patients stratified as high risk garner the most advantages, which contribute to maximum reimbursements for medical treatments.

Medical call centers have taken on the significant task of not only caring for the acute needs of primary care patients but also the chronic needs of vulnerable, high-risk patients as well. Successful coordinating and transitioning care is central to every health system’s strategy. Nurses are the clinicians assigned to figure out how to morph from case management to transitional care coordinators.

Training nurses in the fundamentals of remote patient care is imperative and is based on the standards of care used by telephone triage nurses. The practice of triaging acute symptoms will serve as the starting point for nurses involved in coordinating care.

We must continue to proclaim the unlimited value of a medical call center to the healthcare industry. In many healthcare organizations, more than 10 percent of employees spend the majority of their day doing their job on the telephone. The benefits of centralizing and consolidating the work they do are undeniable.

The task at hand is capturing the limited attention of decision-makers and educating them on the role medical call centers play in a fee-for-value system and the distinct results that are possible. The political future of healthcare may be uncertain, but there remains a need for products, services, and expertise that bring the call center to the forefront of patient care.

Gina Tabone, MSN, RNC-TNP, is the vice president of strategic clinical solutions at TeamHealth Medical Call Center. Prior to joining TeamHealth, she served as the administrator of Cleveland Clinic’s Nurse on Call 24/7 nurse triage program.

The Importance of Channel Consistency



By Peter L. DeHaan

Peter DeHaan, Publisher and Editor of Connections MagazineI wrapped up last year by buying a lot of products online—well, at least it was a lot by my standards. Some items were gifts, a few were for myself as I took advantage of Christmas sale prices, and the rest were for work to complete purchases before the fiscal year ended. As I investigated options and made my selections, I interacted on more than a few occasions with various customer service channels.

Though far from scientific, my empirical results can inform and encourage us.

Web Chat: As a consumer I’ve never been a big fan of chat services. Though my typing speed is decent, my accuracy isn’t. Plus, as a recovering perfectionist, I double-check and triple-check my words and their meaning before I click “send.” A phone call, assuming that option is available, seems so much more effective.

Plus my past encounters with web chat were never good. Sometimes a rep never came online, other times the delay between responses was unbearable, and many times the rep never really answered my questions. Once after a response that was completely off topic, I made the mistake of typing, “Did you even read my question?” The rep’s response wasn’t kind. These experiences conditioned me to avoid web chat.

Things have changed, however. My recent web chat experiences were all great, approaching excellent. (I imagine hearing a collective sigh of relief from all of you who provide this service.) Each time I received the help I sought in a timely manner. The reps responded to my chat requests quickly and answered my questions fully, engaging me in the process. One of the best was from a well-known computer company. I asked the rep how many simultaneous sessions she handled. Her answer was three, but she added, “Sometimes they ask us to handle four if we get busy.” I doubt these requests are optional, but it was refreshing for her to use the word ask instead of make.

Phone: With my computer order placed, I later needed to call the company: After a month of shipping delays, they canceled my order. There was something fishy about their explanation, but the result was that I needed to reorder since my original configuration was no longer available. I had two options: go online or call a special number.

I opted to call. I mistakenly assumed the rep at this special number would know about my situation and have a quick, easy resolution to speed my new computer to me. I was so wrong. I spent about ten minutes trying to explain the situation to the phone rep. Once he finally understood, I thought I was seconds away from ordering a new computer. Instead he said, “Let me transfer you.”

The second rep claimed to have no knowledge of my first conversation, but it only took her a couple minutes to understand the situation—and then she transferred me. The third rep, Sylvestor, was the hardest of all to understand, with me pleading for him to repeat—sometimes more than once—what he had said. In the end I caught most of it.

Though I didn’t ask these reps where they were located, their accent suggested a country known for its call centers. This surprised me because I heard that this company had brought their call centers back onshore in response to the outcry of their customers.

Email: Within seconds of hanging up, I received an email from Sylvestor. He confirmed my purchase and provided a link to track its progress. The link didn’t work, and the transaction never showed up in my account. I replied to his email to express my concern—twice. I was still waiting for his response when the computer showed up. My purchase still hasn’t appeared in my account.

This company excelled with their web chat, disappointed with their phone service, and had an epic fail with email. Their channel experiences didn’t align, and I judge them by their weakest channels, not their best one. My three decades as their customer has ended.

Peter L. DeHaan, PhD, is the publisher and editor-in-chief of Connections Magazine, AnswerStat, TAS Trader, and Medical Call Center News, as well as a passionate wordsmith. Connect with him on his personal blogs, social media sites, and newsletter, all accessible from www.authorpeterdehaan.com.

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Beyond the Call Center: Meeting Expectations of Consumers Across Generations



By Christian Szpilfogel

The proliferation of digital devices and always-on networks have entirely transformed how many of us approach and interact with nearly everything in our lives—how we arrange transportation (Uber), how we answer random questions (Google and Siri), and how we communicate with one another (emojis and messaging apps). Why would we not expect to interact with all organizations this way? It’s fast, convenient, and natural for many of us. Isn’t this what we expect from our favorite brands? For example, Amazon’s 1-Click® checkout process is arguably a key reason it’s one of the world’s ten largest retailers. But few organizations offer seamless communications within their digital touchpoints.

Knowing your customer has always been important to business success. Given these newly heightened expectations resulting from digital advancements and trends, understanding how your customer wants to interact with your brand is more important than ever. Gartner, Inc., an information technology research company, predicts the competition for customers will be dominated by customer experience by the end of the decade. Will your organization lead the way in connecting its specific customers’ preferences to communications strategies or follow its rival?

Who Is Today’s Customer? Identifying your customers and their preferences is a fundamental first step in developing your strategy. Making this complex, today’s consumers span a number of generations—ranging from the post-war era to trendy teens and “tweens”—each preferring a different way to communicate with each other and with businesses. And because many or even all of them are your customers, it is important to identify and overcome the challenges you’ll face personalizing interactions with members of each generation.

As you evaluate each key demographic, consider the most traveled customer journeys encountered with your organization and how interaction preferences may differ at various touchpoints. As an example, simple transactions may be preferred over text messaging by Generation X, while financial consulting calls for voice or video.

Consumers in their mid- to late-eighties certainly don’t have the same buying or communications preferences as teens. Acknowledging these differences and personalizing services across the generational spectrum will allow you to excel at customer experience. In order to do so, you must consider trends found within and across these generational groups.

Customer Journeys: Surprisingly, there is a wide gap between organizations’ views of customer satisfaction and what is reported by customers. This has attracted top business thought leaders such as McKinsey and Co. to examine the root cause; a leading one is the difference in how each party views interactions with the other.

Organizations tend to develop and monitor processes at each discreet touchpoint. For example, a customer searching the company website for information is one discreetly managed touchpoint. The resulting web chat for more information is another; the submission of an online purchase form, yet another; and sending the bill, still one more. In many instances, each touchpoint is owned by a separate manager, staffed by a different team, and measured by a distinct key performance indicator.

Customers see all this as one interaction, which management leaders have come to call the customer journey. In your customers’ eyes, making a purchase is a single event. While three of the four touchpoints may have been handled perfectly, failing in the fourth one renders the entire journey dissatisfying. Without taking a holistic view of the journey, simply emphasizing two opposing key performance indicators at two different touchpoints may set the system up for failure.

Mature Customers and Their Journeys: Once you know your customers, you can segment how each key demographic approaches the highly used customer journeys. A banking institution may start with retirees and people peaking in their careers, as these demographics consume more services and hold higher balances than younger generations. Considering retirees, the highly traveled journeys may include receiving investment advice and managing IRA accounts. Their preferred touchpoints are probably paper or email statements, voice calling, in-person visits, and even video chat. Not only will these modes of communication be more generally preferred by the target demographic, but the sensitivity and complexity of the information transmitted are inappropriate for text messaging and SMS. And forget about social media.

Digital Natives Prefer Mobile and Social: Younger generations overwhelmingly prefer using their smartphones to do just about everything. This ranges from shopping online and surfing the Internet to keeping in touch via text, checking email, Twitter, or Instagram. A recent study showed that younger smartphone users (ages 18 to 29) primarily use their phones to avoid being bored. Unlike older generations, they rarely use them to make phone calls but instead prefer texting, tweeting, or using a digital app to execute everyday tasks such as ordering a pizza; calling to place the order is considered a last resort.

When considering customer journeys for this demographic, think digital. The more automated, digitized, and in-app the touchpoints are, the better. If you can, insert hooks into social media platforms to post winning moments in real-time. When that perfect pair of shoes is customized and ordered, help your proud customer tell the world.

It’s Time to Move Beyond Simple Call Centers: Most of today’s consumers are self-reliant and happy to manage their relationships with businesses using minimal human interaction. They expect the flexibility and convenience of communicating using the methods of their choice anytime, whether that’s the Internet, mobile apps, email, text messaging, social media, or even a phone call. Companies unequipped to serve customers as they wish will not remain competitive for long.

Christian Szpilfogel is the VP of Strategy at Mitel.

Three Aspects of Agent Training



By Janet Livingston

Call center agents, your public-facing staff, are key to your call center’s effectiveness and fuel the success of the overall organization. Successful agent development starts on an agent’s first day of employment and continues every day after that. This begins with initial training, continues with ongoing instruction, and moves into possible promotion and a realistic career path. You must consider all three.

1) Agent Success Starts with Great Training

Training begins on day one of employment. Here are some tips to foster successful agent training.

Pick the Right Medium: There is a time and place for online training, but self-directed instruction will not work in all situations. Some training calls for a classroom setting, where agents can learn from one another as they seek clarification, share insights, and respond to questions. Other times, such as during coaching or call evaluation, effective instruction necessitates one-on-one interaction. This is not to discount self-paced online training, but rather to view it as a secondary resource.

Use Multiple Methods: While some will learn via verbal instruction and visuals, others need printed material or multimedia interaction. To effectively address all learning preferences, employ a variety of teaching tools, such as lecture, PowerPoint summaries, handouts, and interactive multimedia. Allow time for practical application.

Employ Role-Playing: Regardless of how agents learn, practicing that element of work helps establish their competence. Instead of using real callers, a safer solution is role-playing in a classroom environment. While some relish these opportunities, not all will. Yet all agents can learn through role-playing and internalize key proficiencies before applying them to actual callers.

Don’t Assume: When instructing agents, don’t take anything for granted. For example, a hashtag is only a pound sign to some people. Saying “URL” may be clear to some and confuse others, who will instead understand “web address.” Explain everything in detail.

Teach Soft Skills: The focus of agent training is how to use programs, navigate resources, and the most efficient button sequence. Yet callers are more concerned with the agents’ customer service abilities—their soft skills. Teach agents how to truly hear what callers say, convey empathy, and defuse emotions.

Provide Practice Time: Great instruction means nothing without the opportunity to apply it. As the saying goes, “Practice makes perfect.” Build practice time, including role-playing, into all group training. People forget what they hear or see, but what they do stays with them, especially when they repeat it. Athletes call this muscle memory. The same principle applies to mastering agent skills.

2) Agent Success Builds on Ongoing Training

Call center agents should never complete their education. If agents claim to have finished training, either they’re deluding themselves or their call center is letting them down. Agent training isn’t a once-and-done task; it’s ongoing.

Advanced Skills Training: Initial agent training covers basic competencies. Until agents can master fundamental abilities in a real-world setting, it makes no sense to provide additional instruction. However, once agents have the essentials down, they should receive advanced training, such as customer service skills, soft skills, and dealing with unusual caller situations.

Call Evaluation: All call centers record caller conversations. In most operations a quality assurance advisor listens to a sampling of calls to rate them and provide agent feedback. It’s important to address actions needing attention, but feedback should also focus on the positive aspects of the call to reinforce the agent’s great work. To maximize effectiveness the feedback should happen as close to the call as possible.

Corrective Action: In an ideal situation mistakes will never occur. Yet they do. Even the most seasoned and accomplished agents sometimes mess up. While ignoring errors is tempting, doing so is never constructive and only serves to increase the chances of a repeat. Instead meet with the agent as soon as possible to point out the error and offer corrective alternatives. Do this in private without letting other agents know what is occurring. Avoid taking corrective action during the agent’s breaks or after they clock out. Make it quick—say what you need to say and move on.

New Instruction: Call centers aren’t static places. There are software updates, new apps, advanced integrations, and replacement computer technology. In addition new accounts start service and existing clients change processes. Don’t let agents discover these changes in the midst of handling live calls. Provide needed training to fully prepare agents in advance.

3) Agent Success Hinges on Career Development

Agent Onboarding: The primary focus of agent orientation is the initial training. As mentioned, this starts with how to use the computers and associated software, apps, resources, and websites. It addresses basic customer service skills and instructs them how to effectively talk with callers. When agents finish their initial training, their learning is not complete; it has merely begun. Positive initial training helps agents start well and prepares them for a possible call center career.

Continuing Education: Once agents complete their initial training, they shift to ongoing instruction, which should occur to some extent every day they work. As mentioned this can take the form of advance skills training, call evaluation, corrective action, and new instruction on the latest equipment, software, and client processes. Some instruction needs repeating. Occasionally agents need remedial lessons. The point is to never assume agent training is finished. Successful ongoing training moves agents into their future.

Promotional Preparation: Some agents desire to advance in the call center. While this isn’t practical for every agent, it bears noting that most non-agent call center positions are staffed by former agents.

However, just because an employee is a great agent, he or she will not automatically function with distinction in another position. Specialized training is required first. Moving a successful agent into another position prematurely will merely turn a great agent into an ineffective employee. Preparation is key for success. Also coach agents to have patience while waiting for openings.

Career Path: Beyond the call center, other positions in the organization beckon. These may be in sales and marketing, accounting, or technical areas. While few agents arrive possessing the skills to assume these positions, their educational pursuits may point them in that direction. Hiring a freshman accounting major may provide an agent for several years and an accounting department staffer after graduation. Look for these opportunities and groom agents for advancement whenever possible.

Call center agents need training, ongoing feedback, and regular encouragement to develop into valued employees, be it as agents, in the call center, or as part of the greater organization. Agents are the key to successful call centers, and ongoing training is the key to effective agents. Start training today and never stop.

Janet Livingston is the president of Call Center Sales Pro, a premier sales and marketing service provider and consultancy that provides custom training solutions for all levels of call center and telephone answering service staff. Contact Janet at contactus@callcenter-salespro.com or 800-901-7706 to learn more about arranging specific training for your organization.

Top Ten Contact Center and Servicing Goals for 2017



By Donna Fluss

In November and December 2016, DMG conducted a worldwide survey of contact center and enterprise servicing goals for 2017. The results of our annual survey are always interesting, but what makes them useful is that they have proven to be an accurate indicator of company priorities and investments.

Outstanding Service Tops the List: In this year’s study, participants were asked to select their top servicing objectives from thirty-three categories and were invited to write in additional goals. Along with the four write-ins, thirty-seven unique goals were identified in the survey results. The top ten contact center and enterprise servicing goals for 2017, in order of priority, are:

  1. Deliver an outstanding customer experience (60.8 percent)
  2. Improve productivity (56.0 percent)
  3. Improve self-service (50.4 percent)
  4. Reduce cost of service (48.0 percent)
  5. Deliver a personalized customer experience (39.2 percent)
  6. Reduce customer effort (35.2 percent)
  7. Enhance customer engagement (33.6 percent)
  8. Improve customer retention, 33.6 percent
  9. Improve cross-departmental coordination (28.8 percent)
  10. Enhance reporting/analytics (27.2 percent)

What’s New in 2017? Company servicing goals and priorities have changed in the past year, although the position of the first two goals—delivering an outstanding customer experience and improving productivity—have been the same for the past three years. Increasing and improving the use of self-service capabilities has increased in importance. DMG expects to see investments in intelligent virtual attendants and bots, as well as enhancements in web self-service capabilities.

Reducing the cost of service decreased slightly in importance this year, although it’s still a factor companies are taking into consideration when making investments. This is an indication that companies are going to invest in initiatives that prioritize customer needs even if they do not save money, although many investments that improve the customer experience also reduce operating costs.

Delivering a personalized customer experience showed up on the list of contact center and servicing goals for the first time in 2017. This is an area of major investment for companies and an example of a servicing goal that may not reduce operating costs but will improve the customer journey. Companies are finding their customers expect a personalized service experience in their channel of choice. DMG expects to see significant investments to address this objective during the next few years. Personalization is greatly enabled by analytics, the tenth-ranked goal on the list.

Reducing customer effort, a goal that burst onto the enterprise landscape for the first time in 2015, has been slightly de-prioritized for 2017. Companies are doing their best to make it easy for their customers to transact business, but they find it difficult to measure this goal and therefore are investing in and prioritizing related areas. Enhancing customer engagement is a more measureable goal, and it’s one that increased in importance for 2017. This goal is tightly related to improving customer retention, which maintained the same position as the last couple of years. Companies are using analytics to determine personalized approaches for engaging their customers. These initiatives, which should include making it easier for their customers to take care of business, have a proven correlation to retention.

As companies strive to deliver a consistently outstanding customer journey for each customer, they are starting to appreciate the value and benefits of improving cross-departmental coordination. This goal increased in importance in 2017, and though not sexy, it can pay great dividends. This is especially true for companies that figure out how to break down organizational boundaries and look at the company through the eyes of their customers, who do not care which department they interact with as long as things are done the way they expect.

Last, enhancing reporting and analytics dropped significantly in importance in the 2017 list of goals. This is an indication that vendors are finally listening and responding to the needs of their customers for better reports and analytics, not that companies care less about this essential goal. Customer and employee analytics are a necessity for companies to deliver on many of the top ten goals in 2017.

Final Thoughts: The new goal in the list of service priorities for 2017 is delivering a personalized customer experience. Enterprises are realizing they need to make substantial investments to make it easier for their customers to do business in order to engage and retain them. Analytics is key to helping companies figure out how to deliver a personalized experience. At the same time, analytics can help reduce costs, improve the customer experience, and retain customers, which are also top-ten goals for companies in 2017.

Donna Fluss is president of DMG Consulting LLC. For more than two decades, she has helped emerging and established companies develop and deliver outstanding customer experiences. A recognized visionary, author, and speaker, Donna drives strategic transformation and innovation throughout the services industry. She provides strategic and practical counsel for enterprises, solution providers, and the investment community.

Optimize Training Time and Cost



By Kathy Sisk

Every manager knows it’s crucial to expand employees’ knowledge and skills. Call center agents need ongoing training to improve competency, achieve quality performance, and deliver excellent service. Plus, system changes, product launches, and process improvement all require training.

However, programs need careful planning to maximize the training time, minimize costs, and make a good return on investment. Therefore, efficient training is important. Consider the following:

Assess Training Programs Thoroughly: A common mistake is to implement a training program without first determining the needs of agents. For example, sales training isn’t the solution to low-close ratios if agents don’t believe in the product. In this case focus on improving the agents’ morale now and invest in sales training later.

Consider Coaching: Efficient training doesn’t have to be stringent. Regular agent coaching sessions may be enough to address needs and improve performance. Provide relevant advice that agents can use to deal with callers. Informal interactions are an effective form of communication and a big help in enhancing agents’ product understanding.

Agents have different strengths and weaknesses. You can enhance their performance if you don’t focus on just one area; provide training that develops and sharpens a variety of skill sets.

Determine the Appropriate Training Method: These days the most popular forms of training are e-learning and classroom sessions. Pick the approach that most effectively achieves your goals. Each has pros and cons, so choose the method that optimizes time and cost.

  • Classroom sessions are more expensive because it requires you to pull agents from the floor and increase staff hours to cover their work. You may incur additional costs such as meeting room space or printing materials. However, classroom sessions excel in teaching soft skills, such as sales and customer service enhancements.
  • E-learning is cost-effective and convenient. Agents learn at their own pace, and scheduling is easier. E-learning sessions are typically shorter than classroom sessions and are effective for product and process knowledge training.

Design Programs That Support Your Goals: First set training objectives, and then develop programs to achieve them. For example, to focus on call resolution, training should enhance agents’ ability to ask the right questions, solve problems, and improve product knowledge.

Invest wisely in training to maximize results.

Kathy Sisk Enterprises Inc. has forty years of experience providing call center set up, reengineering, assessments, training, script development, and project management services to centers globally.