Best Practice Winner: UCLA Health

Best Practice Awards,

We recently announced the 2023 PAC Best Practice Award Winners. This award recognizes members who have developed and implemented advances in patient access based on innovative approaches to the timely delivery of convenient, patient-centric care in the ambulatory enterprise of our organizations.

Now, we're taking a closer look at the best practices that won. This week we're spotlighting UCLA's best practice: "Restructuring of the Organization to Increase Efficiencies and Improve Performance."

Restructuring of the Organization to Increase Efficiencies and Improve Performance

Led by Jeanette Aguilar, Senior Operations Manager for Workforce Optimization; Jeff Butler, Chief of Operations, Community Clinic Network; and Connie Lee, Operations Director (Patient Communication Center), Patient Access Organization

UCLA Health

Written By Connie Lee

A patient’s first experience with any healthcare system generally begins with a call to the organization’s core call center operations. At UCLA Health, these calls are received by the Patient Communication Center (PCC), comprised of a primarily remote workforce of over 550 FTE strong and growing. An impressive average of 100,000 calls a week are managed through the PCC. With 4.7 million calls handled annually across a multitude of specialties, managing these calls with the intended goal of first-call resolution to get our patients to see the right provider at the right time and at the right place is no easy feat.

Joining the UCLA Health team in June of 2022, I walked into an organization that had been challenged, as many other institutions were, by the COVID-19 pandemic in 2020 as team members from two separate on-site locations quickly moved into a remote work environment. Over two years later, as I onboarded, I immediately noticed the distinctly different cultures and dynamics of the teams, separated by the two physical sites they previously represented. Looking to optimize a future “one PCC team” operation, my immediate challenge was to bring the team together. My first year has been an exciting challenge to focus first on how to build team identity and how best to synergize our workflows to provide patients and families with a branded UCLA Health experience when contacting the PCC. Equally important was to provide a branded experience of what it means to be a valued PCC team member within our newly formed Patient Access Organization.

Onboarding to a new organization as complex as UCLA Health was quite a challenge in this remote environment. But I was ready for it! During my first months of onboarding, I focused on an initial set of priorities:
  1. Moving our organization to be in alignment with industry standards and best practices,
  2. Improve (internal and external) communication, 3. Increase transparency of data-based decision-making and performance and team management, and 4. Building trust across the team and our clinic partners.
My goal was, and continues to be, to commit to building a high-performing team to solidify the PCC foundation. This will prepare us for future expansion of the PCC operations as we continue to onboard new UCLA Health clinics to our scheduling support infrastructure.

My initial set of priorities resulted in a realignment of internal resources to have my team run more efficiently. We restructured into scheduling pods which was a great opportunity for our team members to experience the benefits of streamlined calls. Instead of receiving calls from a variety of different specialties, our focus was to streamline their inbound calls specific to their respective teams and scheduling pods. The primary change they experienced was positive, as the restructuring efforts led to immediate improvements in managing their daily expectations of what calls they would receive more efficiently. The supervisors also enjoyed a positive change, as they were now overseeing a more manageable ratio of agents based on industry-standard ratios (for supervisor to agent). The operational managers adapted well to the change, as some experienced a different scope of oversight while others felt relief to their oversight responsibilities. I made sure that all my decisions were aligned with their job descriptions, which helped to support the operational changes I was making. The transformation has
been rewarding for the leaders, as they have seen significant improvements in achieving our department performance metrics because of moving into scheduling pods (versus independently functioning teams). They have also benefited greatly from having sufficient supervisory coverage for their respective teams, which allows them to manage at a higher level and continue to develop their leadership skills.

When I joined the organization, performance metrics were hovering in the double digits for abandonment rates (AR), with our average speed to answer (ASA) at 2 minutes and 30 seconds and service levels (SL) below 60%. This was, of course, not the level of support and service we wanted to provide our patients. Within a few months after transitioning into our scheduling pods, we started seeing improvements to our performance, meeting our AR performance metric for the first time in March of 2023 at 5%, with continued sustained improvement ending our FY 23 meeting/exceeding all of our core call center KPIs (in June 2023 we had 3.2% AR, 0:29 ASA, 80% SL). Our overall reported patient complaints have decreased tremendously with the improvements in our service levels, and we will be looking to further evaluate how to measure first-call resolution and patient satisfaction from their call experience in the year ahead.

What has surprised me the most during this first year of change was how quickly the restructuring was able to demonstrate meaningful results that have motivated the team. The immediate results really helped to gain momentum with buy-in across the entirety of my team, as well as build our reputation across the enterprise to be recognized as a solid support infrastructure for our patients who are trying to access care at UCLA Health. I am so proud of the team for their achievements in such a short amount of time, and am looking forward to a bright future of continued success and growth.

My main advice for access leaders looking to optimize their call center operations? It’s truly more than just “fixing the call center,” as I’m sure many are tasked with in your current role. With a focus and commitment to setting your team up for success, you can’t go wrong. While we still have our fair share of challenges to navigate through in our journey of building a high-performing team, centering my true north on taking care of my team has never led me astray. I hope my experience is a reminder for all leaders to always focus on your people in your organization’s access journey! Also, it’s important to be supported by leadership that is supportive of your approach. The days are long, but the months (and, for me, this past year) go by quickly! I am grateful for my leadership and my team for continuing to inspire me on the toughest days and inspiring me to want to do better for our patients. And the cherry on top of my access journey is that I’m having fun along the way! Best wishes to you in your access journey!