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Unprecedented Staffing Concerns Overcome for Busy Wisconsin Hospice

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Empty Office Chair and DeskThedaCare at Home, a hospice and home-health provider located in Appleton, Wisconsin, was facing unprecedented staffing concern. “There were four people positioned for retirement,” Bobbie Thompson, Manager of Clinical Office Operations at ThedaCare at Home recalls, “And we weren’t in a state to replace them.”

With another nurse on FMLA leave, the pending departures of some of their most senior nurses left the already resource-thin hospice team feeling uncertain about the future.

With over 75 to 100 calls a day, one on-call nurse wasn’t going to be sufficient. “We were under minimum staffing,” Thompson explains, “It was a stressful time for nursing staff and leaders.”

Thompson said they considered several options to bridge the gap. She asked the ThedaCare at Home Human Resources department to help with the hiring effort. They combed the database of over 6700 current nurses, but they weren’t able to find the needed replacements quickly. Thompson and other administrators considered cross-training for the current team, but that didn’t seem to be the ideal situation either. “We weren’t sure what we were going to do,” Thompson remembers.

GROWING PATIENT & CAREGIVER EXPERIENCE CONCERNS

Staffing concerns only compounded the already existing challenges with patient and caregiver experience during evening and weekend hours. ThedaCare at Home nurses relied on the support of a non-clinical answering service to help answer caregiver calls, but there had been growing concern over long wait times of up to twenty minutes.

The on-call nurses were struggling to keep up with the volume of calls. And it was going to be more challenging without their veteran nurses. Thompson knew that any solution they found for the staffing crisis also had to address the challenges they were experiencing with their answering service—no easy task. Thompson remembers the overwhelming challenge: “Things started to become more urgent. We were in a perfect storm.”

AN UNEXPECTED SOLUTION
Something had to be done—and fast. Thompson hadn’t found the ideal solution to her staffing and patient experience challenges when she received a call from Total Triage specialist Michelle Olsen.

“Michelle listened to my concerns,” Thompson remembers, “And was able to present creative solutions.” A few months later, when the situation had become urgent, Thompson remembered her call with Olsen, and she knew Total Triage was the answer.

Nurse with HeadsetTotal Triage offered the additional layer of clinical support ThedaCare needed. Calls would be answered by registered nurses with hospice training—unlike the operators at their current answering service. The Total Triage nurses offered the higher level clinical thinking to receive, assess, and triage the calls appropriately, which Thompson and the others at ThedaCare saw as invaluable.

Additionally, Thompson appreciated that Total Triage offered scalable services based on demand. Because the partnership was intended to be short-term until ThedaCare at Home overcame their staffing crisis, she needed a partner who could begin providing the value immediately without long-term requirements.

The Total Triage was able to work with the ThedaCare at Home IT department to integrate the Total Triage call and documentation platform with the existing AllScriptsTM platform. Thompson said they went above and beyond to get the systems in place, “They amazed me. They were problem-solvers. They were idea-people.”

Total Triage was able to respond to the specific needs of ThedaCare at Home quickly. “If you are going to try something in the toughest of scenarios—it has to work,” explains Thompson.

REINFORCEMENTS ARRIVE
Only days after signing up for service, ThedaCare at Home begin sending their calls to Total Triage. Thompson remembers the quick turnaround time, “They received the information one day to start helping us the next.”

Thompson says it was like sigh of relief when ThedaCare at Home went “live” with Total Triage: “There was an element of relief, “ she says, “it was like special forces were coming to help.” The ThedaCare at Home nurses now knew they backup when they needed it most.

Thompson and her staff soon discovered that Total Triage was more than a service provider—they were a true partner in care. “They went above and beyond in effort, they took everything to heart, and were willing to teach and learn,” Thompson explains.

Together, the Total Triage team and ThedaCare at Home team addressed every challenge the hospice provider had been facing. With the additional support from Total Triage, the busy hospice provider had the time they so desperately needed to begin rebuilding their team without jeopardizing patient and caregiver experience.

SUPERIOR PATIENT CARE
Thompson explains that although the relationship with staff was an important part, the quality of the patient and caregiver support was most critical. She tells of her confidence in the caregiver and patient experience with Total Triage, “My patients wouldn’t have gotten this kind of customer service with anyone else.”

The ThedaCare at Home team quickly saw the difference in skill the nursing triage provider had from traditional answering services. With clinical training, Total Triage were able to resolve non-emergent calls while properly triaging calls to the ThedaCare on-call nurse when appropriate. Patients and caregivers were able to talk to a registered nurse within minutes, without ever experiencing a disruption in care.Nurse Tenderly Caring for Elderly Patient

“We wouldn’t have been able to handle the call volume without Total Triage” Thompson admits, “It could have resulted in delay or patient risk.” In fact, they found the call volume was nearly cut in half with Total Triage support, reducing the total call volume to ThedaCare at Home on-call nurses to less than 50 calls per day. This ensured the most emergent calls received the attention they needed.

Thompson believes the partnership with Total Triage increased the overall patient satisfaction score because patients had support within minutes. “The transition of care from ThedaCare to Total Triage was as seamless as it can be,” she adds.

STATE-OF-THE-ART TECHNOLOGY
In the healthcare world where documentation is so important, the Total Triage software platform was another benefit. ThedaCare at Home staff members found it was easy to use and navigate. Even nurses with limited technological experience were able to use the system on the first day of logging on.

The Patient Documentation Portal (PDP) allowed Thompson and her team to access call information easily and quickly, allowing for a seamless transition of care.

Nurse reading reportsThe Daily Call Log gave Thompson the oversight for which she had hoped. Reports were printed every morning to provide a concise “snapshot” of everything that had happened during the night. And she knew she could listen to the calls whenever she wanted.

The advanced call recording technology also gave Thompson and her team peace of mind. Because all Total Triage calls are recorded, there was never a question as to how a certain patient/caregiver call was handled. Thompson explains how the call reporting feature was used: “If we had questions about a patient call, I would request the recording. I would have the recording within a matter of minutes, and an Total Triage nursing manager and I would listen to the call together to problem solve.”

BONUS BENEFITS
Partnering with Total Triage had another positive effect that Thompson didn’t anticipate. She says that the partnership has provided a “jumpstart” in the efforts to document and streamline ThedaCare at Home internal policies and processes.

Having relied on veteran nurses for years, ThedaCare at Home hadn’t had an eminent need for clearly written guidelines. But writing policies to facilitate the partnership with Total Triage helped them better define organizational standards. “It allowed us to self-reflect on how to improve processes and communication, “ she says, “which has greatly helped us in the training efforts.”

CRISIS AVERTED
Outdoor portrait of medical team
With Total Triage support, ThedaCare at Home was able to overcome their staffing crisis. The partnership gave them the critical time they needed to hire and train new nurses, while simultaneously addressing how to improve patient and caregiver satisfaction and their own processes. “In our experience, Total Triage was a team-saver.”

Thompsons says she wouldn’t hesitate to recommend Total Triage to other hospice and home-health companies. “In our experience, Total Triage was a team saver,”she explains, “they delivered on everything they said they would do.” After six months with Total Triage, ThedaCare at Home was positioned to handle all their incoming calls again. But Thompson says she will never forget how appreciative she was for the triage company: “The partnership with Total Triage had multiple benefits for us: they cared for our patients, gave our team the hope to get through a difficult time, gave us space to improve our processes – you can’t put a monetary amount on that.”

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