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A management on-call program at Crozer-Keystone Health System in Upland, PA, is giving an increased sense of security to access employees working other than normal business hours, while more evenly distributing the load of after-hours help calls received by managers and supervisors.
An on-call beeper is rotated weekly among six members of the registration/financial services management team, which means that during five of every six weeks all but one can count on having no work interruptions at home, says Raina Harrell, director of registration and financial services for Crozer-Chester Medical Center.
An integral part of the program, Harrell notes, is a management on-call folder in which she assembled comprehensive information on the three Crozer hospitals she oversees.
The pocket of that folder includes the work schedules for all three registration/financial services areas — emergency department (ED), outpatient registration, and financial services — and is updated monthly, Harrell says.
Inside are the names of all employees — listed by hospital and by work area — with their telephone numbers and the other areas in which they are qualified to work, if necessary, she adds.
That information alone is a major help to supervisors and managers who may be taking calls from areas of the health system whose staffs and schedules are not familiar to them, Harrell points out.
"One important benefit is communication," she says. "All six of us — myself, a manager, and four supervisors — have a folder, as does Tony Bruno, the corporate director of registration and financial services. If a [staff] issue comes up, he can look and see who’s in that area at that time.
"The best benefit," Harrell adds, "is that employees know we’re there for them 24 hours a day. They always have this number, and they don’t feel like they’re bothering someone if they use it because that person is on-call."
Before the on-call program was in place, she says, the ED supervisors — particularly the one at the main hospital — were inundated with calls. "People called any time of day if there was a problem with, for example, a registration screen."
Two months into the program, Harrell says, employees had become accustomed to calling only the on-call person, and also were less likely to call for minor problems. "If you’re calling a superior who doesn’t supervise your area, doesn’t know your registration pathways, it really puts the onus on you [to come up with the solution]," she points out. "Employees started answering their own questions.
"The volume has really gone down," Harrell adds. "In the beginning, [the on-call manager] might get 10 to 12 calls. Now it’s one or two."
One reason for the change in calling patterns, she explains, are the "management scripts" that Harrell wrote and inserted into the on-call folder. (See scripts.) To promote consistency in the way the different managers and supervisors handle calls, there are scripted responses for three scenarios, Harrell says. That includes the occasions when the question is less than urgent and could have been left on a supervisor’s voice mail, she notes. "They’ve gradually learned not to call for things that can be handled the next day."
Source: Crozer-Chester Medical Center, Upland, PA.
The most common reason for an on-call manager to be contacted, Harrell says, is that an employee has called to say he or she won’t be coming in to work. To make handling that situation easier, the various sections of the on-call folder are color-coded according to hospital and work area, she notes. There are short profiles on each employee, with instructions on what to do if that person "calls out," Harrell adds.
The management staff particularly like the on-call folder because it keeps them apprised of who’s working in every registration/financial services area in the three hospitals, she points out. "The system is so large, sometimes we don’t communicate changes in staff. This keeps us communicating all the time, and people get used to areas other than their own."
One supervisor liked the on-call experience she had with another facility so much that when a position came open there, she asked to take it, Harrell says. And because she put together the on-call schedule for the entire year, she adds, the staff know when they’re on-call and can switch weeks to accommodate vacations. "They’re now waiting for next year’s schedule to come out."