2011 AFMC 24/7 Survey Results

2011 AFMC

Executive Summary ... 3

Survey Methodology ... 5

Demographics of Survey Sample and Respondents ... 7

Flow Diagram of Live Voice Calculation ... 9

Providers’ Responses by Current Medicaid Caseload ...11

Providers’ Responses by Geographic Region ...15

Verification of Survey Responses ...19

Recommendations ...21

Appendix A: Survey Tool ... 23

Appendix B: County-Level Map ... 25

Appendix C: Frequency and Verification Tables ...27

Table

Executive

Summary

T

he Arkansas Foundation for Medical Care (AFMC) surveyed all Arkansas Medicaid primary-care physicians with a caseload of 100 or more Medicaid beneficiaries (N=801) to determine what happens when a patient calls their clinic after normal business hours. Please refer to Appendix A for the survey tool. After conducting a phone-only survey administration, AFMC received 456 completed surveys from providers in May 2011, resulting in a response rate of 66.09%. Two hundred thirty-four (33.9%) of the providers declined to answer the survey. This report provides a summary of the overall survey results and compares the survey results by current Medicaid caseload and geographic region. This comprehensive analysis will assist DMS to determine how often patients are able to speak with someone when they call a clinic after normal business hours.

KEY FINDINGS

n Overall, 55 percent of providers provide an after-hour call system where their patients are able to speak with a live person who include clinic personnel, the on-call physician, an answering service, a clinical triage system or the hospital staff. Please see Appendix B for this calculation of live responses and the county level map in Appendix C.

n At least six in 10 providers have their office phone number listed on a website or the Internet.

n Approximately half of providers include a call event in the patient’s medical record.

n Approximately half of providers provide an answering machine where patients leave messages for after-hour calls. When a patient reaches an answering machine, seven in 10 providers instruct patients to leave a mes-sage and go to the ER in case of an emergency, while almost three in 10 providers instruct patients to contact an answering service.

n At least one in three providers uses an answering service. When a patient reaches an answering service, at least half of the providers page an on-call professional who responds within 20 minutes.

n Less than 3 percent of providers provide direct contact with an on-call physician.

n Out of the 93 phone calls that were made for verification, 69 (74.19%) providers’ after-hour system matched their survey responses. Twenty-four (25.81%) providers’ after-hour systems did not match their survey responses.

Survey

Methodology

T

his report summarizes results derived from the 24-7 Survey, which consists of 13 questions. Please refer to Appendix A for the survey tool. The survey contains four dichotomous questions scaled as “Yes/No,” two open-ended questions and two nominal questions to select only one response option. Additionally, there are five multiple-answer questions where the respondent should select all responses that apply to them.

For the “Yes/No” and “select only one response” questions, results are presented as percents and sum to 100 percent. For the “check all that apply” questions, results are presented as utilization rates because the respondent could select multiple answers.

AFMC pulled a list of primary-care providers that had a caseload of 100 or more Medicaid beneficiaries. Some providers share the same phone number. The assumption was made that the phone numbers dialed would have the same type of answering service for all providers with the same phone number. Therefore, the responses were multiplied by the number of providers at the clinic. The outreach team called each clinic asking them to partici-pate in the survey, which would only take a few minutes of their time. Only the first eight questions were asked for these providers. Calls were made the week of May 16 through May 20. Phone calls where the phone number was disconnected, a wrong number or the office was closed were considered non-answered calls. Out of 801 phone calls, 690 clinics answered their phone and 456 clinics completed the survey.

SURVEY

2011

Survey sample size 801

Total clinics answered phone 690 Phone answer rate 86.14% Total clinics complete survey 456

Completion rate 66.09%

Demographics of Survey

Sample and Respondents

A

FMC compared the survey sample to the providers that responded to the survey. The table below shows the percentage of respondents by demographic category: geographic region and current Medicaid caseload.

DEMOGRAPHIC

CATEGORY

SAMPLE RESPONDENTS

Region Central 20.60% 16.45% Northeast 21.60% 21.71% Northwest 34.46% 41.67% Southeast 11.74% 9.43% Southwest 9.99% 9.65% Out of State 1.62% 1.10%

Current Caseload* Less than 200 25.09% 24.34%

200 to 349 24.09% 25.44%

350 to 649 24.47% 25.44%

More than 650 26.34% 24.78% *Current Caseload as of April 14, 2011.

The counties within Arkansas’ geographical regions are shown below.

Northwest: Baxter, Benton, Boone, Carroll, Conway, Crawford, Franklin, Johnson, Logan, Madison, Marion,

New-ton, Pope, Scott, Searcy, Sebastian, Van Buren, Washington and Yell counties

Northeast: Clay, Cleburne, Craighead, Crittenden, Cross, Fulton, Greene, Independence, Izard, Jackson,

Law-rence, Mississippi, Poinsett, Randolph, Sharp, Stone, White and Woodruff counties

Central: Faulkner, Garland, Grant, Lonoke, Perry, Pulaski and Saline counties

Southwest: Calhoun, Clark, Columbia, Dallas, Hempstead, Hot Spring, Howard, Lafayette, Little River, Miller,

Montgomery, Nevada, Ouachita, Pike, Polk, Sevier and Union counties

Southeast: Arkansas, Ashley, Bradley, Chicot, Cleveland, Desha, Drew, Jefferson, Lee, Lincoln, Monroe, Phillips,

Flow Diagram of

Live Voice Calculation

ALL RESPONDING PROVIDERS

n=456

Q5 does not contain B

n=149

Q6 does not contain B or C

n=37

Q4=Five or more

than one response

n=18

Q6 contains B or C

n=128

Q7 contains A-F

n=52

Q8 contains A-D

n=10

Q5 contains B

n=62

No Live Voice

n=204

Live Voice

n=252

Providers’ Responses

by Current*

Medicaid Caseload

Q2) Where is your office

phone number listed?

Check all that apply.

Less

than 200

n=111

200

to 349

n=116

350

to 649

n=116

650

and more

n=113

All

Respondents

n=456

Phone book 99.10% 100.00% 100.00% 100.00% 99.78% Website/Internet 65.77% 68.97% 68.97% 66.37% 67.54%

Specific handouts with instructions for patients

72.07% 79.31% 87.07% 83.19% 80.48%

Other 17.12% 23.28% 35.34% 28.32% 26.10%

Almost all providers have their phone number listed in the phone book, at least six in 10 providers list their phone number on a website/Internet, and at least seven in 10 providers give handouts to their patients with their phone number. Of the other areas where providers list their phone number, they also list their phone num-ber on appointment cards, business cards, newspaper and any advertising materials.

Q3) When a patient calls

after hours, does the

call event get included

in the medical record?

Less

than 200

n=110

200

to 349

n=116

350

to 649

n=116

650

and more

n=113

All

Respondents

n=453

Yes 44.55% 53.45% 43.97% 59.46% 50.33% No 55.45% 45.69% 53.45% 37.84% 48.12% Don’t know 0.00% 0.86% 2.59% 2.70% 1.55%

Providers with less than 200 Medicaid beneficiaries on their caseload and providers with 350 to 649 Medicaid beneficiaries on their caseload are significantly less likely to place the call event in the patient’s medical record compared to providers with 650 or more Medicaid beneficiaries on their caseload.

Q4) What happens when

patients call the office

after hours?

Less

than 200

n=108

200

to 349

n=113

350

to 649

n=110

650

and more

n=108

All

Respondents

n=439

Answering machine where patients leave messages

55.56% 51.33% 41.82% 43.52% 48.06%

Answering service 38.89% 38.05% 37.27% 36.11% 37.59%

Clinical triage service (example: nurse hotline)

2.78% 7.08% 20.00% 17.59% 11.85%

Direct contact with on-call physician

2.78% 3.54% 0.00% 2.78% 2.28%

Other 0.00% 0.00% 0.91% 0.00% 0.23%

About half of providers provide an answering machine where patients leave messages for after-hour calls. At least one in three providers uses an answering service to answer calls after hours. Providers with 350 or more Medicaid beneficiaries on their caseload are more likely to use a clinical triage service compared to providers with less than 350 Medicaid beneficiaries on their caseload.

Q5) What happens when

a patient reaches the

answering machine?

Check all that apply.

Less

than 200

n=60

200

to 349

n=58

350

to 649

n=46

650

and more

n=46

All

Respondents

n=210

Leave message with office, instructed to go to ER if urgent

90.00% 68.97% 60.87% 71.74% 73.81%

Instructed to call another number to contact answering service

25.00% 17.24% 36.96% 43.48% 29.52%

Leave message to be monitored by clinic personnel every few hours

0.00% 0.00% 2.17% 0.00% 0.48%

Messages are reviewed in the morning.

76.67% 77.59% 50.00% 54.35% 66.19%

Q6) What happens

when a patient reaches

an answering service?

Check all that apply.

Less

than 200

n=41

200

to 349

n=40

350

to 649

n=37

650

and more

n=37

All

Respondents

n=155

Leaves messages with office in the morning, instructed to go to ER if urgent

26.83% 32.50% 21.62% 16.22% 24.52%

Page professional on call who responds within 20 minutes

75.61% 52.50% 56.76% 56.76% 60.65%

Other 21.95% 20.00% 32.43% 37.84% 27.74%

Three in four providers with less than 200 Medicaid beneficiaries on their caseload page a professional on call who responds within 20 minutes after a patient reaches an answering service.

Q7) What happens when

a patient reaches a

triage service? Check all

that apply.

Less

than 200

n=3

200

to 349

n=8

350

to 649

n=22

650

and more

n=19

All

Respondents

n=52

Licensed professional reviews clinical problem

66.67% 87.50% 100.00% 89.47% 92.31%

Licensed professional offers treatment advice

66.67% 87.50% 100.00% 73.68% 86.54%

Licensed professional prescribes medication

0.00% 0.00% 9.09% 0.00% 3.85%

Licensed professional contacts office staff for serious problem

66.67% 75.00% 90.91% 73.68% 80.77%

Licensed professional refers patients to ER without contacting office staff

66.67% 37.50% 31.82% 10.53% 26.92%

Other 33.33% 12.50% 4.55% 10.53% 9.62%

Q8) What happens if

office staff answers

after hour calls? Check

all that apply.

Less

than 200

n=3

200

to 349

n=4

350

to 649

n=0

650

and more

n=3

All

Respondents

n=10

Each physician covers own patients every night/ weekend

66.67% 0.00% 0.00% 0.00% 20.00%

Practice personnel share calls

33.33% 50.00% 0.00% 0.00% 30.00%

Practice personnel share calls with other commu-nity practices

66.67% 25.00% 0.00% 66.67% 50.00%

Other 0.00% 25.00% 0.00% 33.33% 20.00%

Providers’ Responses

by Geographic Region

Q2) Where is your office

phone number listed?

Check all that apply.

Central

n=75

Northeast

n=99

Northwest

n=190

Southeast

n=43

Southwest

n=44

All

Respondents

n=456

Phone book 100.00% 100.00% 99.47% 100.00% 100.00% 99.78% Website/Internet 81.33% 55.56% 72.63% 60.47% 52.27% 67.54%

Specific handouts with instructions for patients

88.00% 75.76% 84.21% 69.77% 70.45% 80.48%

Other 42.67% 26.26% 22.63% 16.28% 25.00% 26.10%

Almost all providers list their office phone number in the phone book. Providers in the central and northwest regions are more likely to list their phone number on a website/Internet. At least seven in 10 providers list their phone number in specific handouts with instructions for patients.

Q3) When a patient calls

after hours, does the call

event get included in the

medical record?

Central

n=73

Northeast

n=99

Northwest

n=189

Southeast

n=43

Southwest

n=44

All

Respondents

n=453

Yes 61.64% 45.45% 47.62% 41.86% 56.82% 50.33% No 31.51% 52.53% 52.38% 58.14% 43.18% 48.12% Don’t know 6.85% 2.02% 0.00% 0.00% 0.00% 1.55%

Q4) What happens when

patients call the office

after hours?

Central

n=70

Northeast

n=96

Northwest

n=183

Southeast

n=42

Southwest

n=43

All

Respondents

n=439

Answering machine where patients leave messages

38.57% 50.00% 48.63% 57.14% 53.49% 48.06%

Answering service 24.29% 31.25% 44.26% 38.10% 37.21% 37.59% Clinical triage service

(example: nurse hotline)

37.14% 16.67% 4.92% 2.38% 0.00% 11.85%

Direct contact with on-call physician

0.00% 2.08% 1.64% 2.38% 9.30% 2.28%

Other 0.00% 0.00% 0.55% 0.00% 0.00% 0.23%

At least half of the providers in the northeast, southeast and southwest regions provide an answering machine where patients leave messages. Providers in the central region are more likely to use a clinical triage service when a patient calls the office after hours. Approximately 9 percent of clinics in the southwest region provide direct contact with an on-call physician when a patient calls the clinic after normal business hours.

Q5) What happens when

a patient reaches the

answering machine?

Central

n=27

Northeast

n=48

Northwest

n=89

Southeast

n=23

Southwest

n=23

All

Respondents

n=210

Leave message with office, instructed to go to ER if urgent

62.96% 87.50% 60.67% 86.96% 95.65% 73.81%

Instructed to call another number to contact answering service

59.26% 16.67% 37.08% 13.04% 8.70% 29.52%

Leave message to be monitored by clinic personnel every few hours

0.00% 0.00% 0.00% 0.00% 4.35% 0.48%

Messages are reviewed in the morning

74.07% 70.83% 65.17% 60.87% 56.52% 66.19%

Q6) What happens when

a patient reaches an

answering service? Check

all that apply.

Central

n=16

Northeast

n=29

Northwest

n=80

Southeast

n=16

Southwest

n=9

All

Respondents

n=155

Leaves messages with office in the morning, instructed to go to ER if urgent

0.00% 31.03% 32.50% 12.50% 11.11% 24.52%

Page professional on call who responds within 20 minutes

75.00% 48.28% 53.75% 93.75% 55.56% 60.65%

Other 31.25% 41.38% 28.75% 0.00% 33.33% 27.74%

At least three in four providers in the central and southeast regions page a professional on call who responds within 20 minutes when a patient reaches an answering service.

Q7) What happens when

a patient reaches a triage

service? Check all that apply.

Central

n=26

Northeast

n=16

Northwest

n=9

Southeast

n=1

Southwest

n=0

All

Respondents

n=52

Licensed professional reviews clinical problem

92.31% 93.75% 88.89% 100.00% 0.00% 92.31%

Licensed professional of-fers treatment advice

92.31% 75.00% 88.89% 100.00% 0.00% 86.54%

Licensed professional prescribes medication

3.85% 6.25% 0.00% 0.00% 0.00% 3.85%

Licensed professional contacts office staff for serious problem

88.46% 62.50% 88.89% 100.00% 0.00% 80.77%

Licensed professional re-fers patients to ER without contacting office staff

30.77% 12.50% 33.33% 100.00% 0.00% 26.92%

Other 7.69% 12.50% 11.11% 0.00% 0.00% 9.62%

Q8) What happens if office

staff answers after-hour

calls? Check all that apply.

Central

n=0

Northeast

n=2

Northwest

n=3

Southeast

n=1

Southwest

n=4

All

Respondents

n=10

Each physician covers own patients every night/ weekend

0.00% 100.00% 0.00% 0.00% 0.00% 20.00%

Practice personnel share calls

0.00% 0.00% 100.00% 0.00% 0.00% 30.00%

Practice personnel share calls with other community practices

0.00% 100.00% 0.00% 0.00% 75.00% 50.00%

Other 0.00% 0.00% 0.00% 100.00% 25.00% 20.00%

Verification of

Survey Responses

D

uring the week of June 6, 2011, AFMC randomly selected 20 percent of the providers that completed a survey to verify what happens when a client calls the clinic after normal business hours. Out of the 93 phone calls that were made for verification, 69 (74.19%) providers’ after-hour system matched their survey responses. Twenty-four (25.81%) providers’ after-hour system did not match their survey responses.

When AFMC dialed the office phone number after normal business hours, 44 providers (47.31%) had an answer-ing machine for the patient to leave a message or directed the patient to the ER or 911 in case of an emergency. Forty-six (49.46%) providers used an answering service to answer phone calls after normal business hours. Only one provider (1.08%) had a medical assistant or health professional answer the call, and two providers (2.15%) did not answer phone calls or provide an answering machine after normal business hours.

For the 46 providers who provide an answering service to answer after-hour phone calls, each of the 46 answer-ing services contacts the practice, and the practice responds within 20 minutes. If the answeranswer-ing service does not reach the practice, then 27 (60.00%) answering services keep calling the practice. Two (4.44%) of these answer-ing services are the practice themselves. Sixteen (35.56%) answeranswer-ing services will have a nurse call the patient to answer questions. Only five (10.87%) of the answering services provide a log of the calls to the practice. But of the 41 (89.13%) answering services that responded that they do not provide a log of calls to the practice, these services stated that they would send a log of all calls to the practice if requested.

Verification: June 6

Verification: June 13

Q9) What happens when office phone number is dialed?

n

%

n

%

Answering machine 44 47.31% 30 73.17%

Answering service 46 49.46% 8 19.51%

Medical assistant or health professional answers the call 1 1.08% 0 0.00%

Keeps ringing/no answer 2 2.15% 3 7.32%

For the eight providers who provide an answering service to answer after-hour phone calls, five providers’ servic-es contact the practice and the practice rservic-esponds within 20 minutservic-es. If the answering service doservic-es not reach the practice, then all services keep calling the practice until someone is reached. None of the five answering services send a log of calls to the practice unless requested by the practice. The other three providers’ services hung up the phone when AFMC began asking survey questions.

Recommendations

T

he results of this survey suggest that the majority of PCPs surveyed are fulfilling their obligations for providing after-hours communications with patients. As illustrated by the county-level map in Appendix C, there are opportunities to improve statewide, particularly in rural areas.

If a priority for Medicaid, further emphasis and technical support might be provided through future new activities by Provider Relations to improve after-hours phone service.

APPENDIX A:

Survey Tool

1) What is your office phone number for patients?

_____________________________

2) Where is your office phone number listed?

(Check all that apply)

An Phone book Bn Website/Internet Cn Specific handouts with

instructions for patients Dn Other

____________________________

3) When a patient calls after hours, does the call event get included in the medical record? 1n Yes

2n No

4) What happens when patients call the office after hours?

1n Answering machine where patients leave messages ➨ Go to Question 5 2n Answering service

➨ Go to Question 6 3n Clinical triage service

(example: nurse hotline) ➨ Go to Question 7 4n Direct contact with

on-call professional ➨ Go to Question 8

5n Other _____________________ ➨ Go to Validation (Question 9)

5) What happens when a patient reaches the answering machine? (Check all that apply.) An Leave message with office,

instructed to go to ER if urgent Bn Instructed to call another number

to contact answering service Cn Leave message to be monitored

by clinic personnel every __ hour Dn Messages are reviewed

in the morning

PROCEED TO VALIDATION (QUESTION 9)

6) What happens when a patient reaches an answering service? (Check all that apply.) An Leaves message with office in the

morning, instructed to go to ER if urgent

Bn Page professional on call who responds within 20 minutes Cn Other _____________________

PROCEED TO VALIDATION (QUESTION 9) 7) What happens when a patient reaches a

triage service? (Check all that apply.) An Licensed professional reviews

clinical problem

Bn Licensed professional offers treatment advice

Cn Licensed professional prescribes medication

Dn Licensed professional contacts office staff for serious problem En Licensed professional refers

patients to ER without contacting office staff

Fn Other

____________________________

PROCEED TO VALIDATION (QUESTION 9) 8) What happens if office staff answers

after-hour calls? (Check all that apply.) An Each physician covers own

patients every night/weekend Bn Practice personnel share calls Cn Practice personnel share calls with

other community practices Dn Other:

_____________________________

VALIDATION OF AFTER-HOURS PHONE SYSTEMS. CALL OFFICE PHONE NUMBER. 9) What happens when office phone number is

dialed?

1n Answering machine (do not leave message) 2n Answering service

➨ Go to Question 10 3n Medical assistant or health

professional answers the call

IF AN ANSWERING SERVICE RECEIVES YOUR CALL, EXPLAIN YOU ARE FROM AFMC AND ASK:

10) When patients contact the service, does the

service contact the practice? 1n Yes

2n NO ➨ Go to Question 13 11) Does the practice respond within 20 minutes?

1n Yes 2n No

12) What does the service do if there is no

response from the practice?

______________________________________ ______________________________________

13) Does the service send a log of the calls to

APPENDIX B:

County-Level Map

T

his county-level map shows the distribution of providers who responded they provide a live voice response when a patient calls their clinic after business hours. The percent represents the percent of providers in a county that provide a live response, and the n value is the number of providers within the county that responded to the survey. The counties shaded in tan have a percent less than the state percent. The counties shaded in blue have a percent greater than or equal to the state percent.

Percent of providers where a patient calls

after hours and speaks with someone

State percentage: 55%

Below state percent

Above state percent

APPENDIX C:

Frequency Tables

_{Appendix D: Frequency Tables} Q2) Where is your office phone number listed? Check

all that apply. Frequency Percent UtilizationRate

Phone book 455 36.43 99.78

Website/Internet 308 24.66 67.54

Specific handouts with instructions for patients. 367 29.38 80.48

Other 119 9.53 26.1

Q2 Other Responses Frequency Percent Cumulative Frequency CumulativePercent

ADS IN LOCAL PAPER 1 1.33 1 1.33

APPT CARD 3 4.00 4 5.33 APPT CARD/BROCHURES 1 1.33 5 6.67 APPT CARDS 1 1.33 6 8.00 Advertising 21 28.00 27 36.00 BILLBOARD/NEWSPAPER/WORD OF MOUTH 1 1.33 28 37.33 BROCHURE/SIGN IN FRONT OF BLDG 2 2.67 30 40.00 BROCHURES/SIGN IN FRONT OF BLDG 1 1.33 31 41.33 BUSINESS CARD 3 4.00 34 45.33

BUSINESS CARD/APPT CARDS 1 1.33 35 46.67

BUSINESS CARD/BROCHURE 1 1.33 36 48.00

Baptist Health website 1 1.33 37 49.33

Beginning Readers 9 12.00 46 61.33

Business cards 1 1.33 47 62.67

DOCTOR REFERRAL LINE 1 1.33 48 64.00

Facebook 7 9.33 55 73.33

Insurance Manuals 12 16.00 67 89.33

PREVENTIVE HEALTH BROCHURE 1 1.33 68 90.67

RADIO/PAPER 1 1.33 69 92.00

SIGN OUT FRONT 1 1.33 70 93.33

appt cards 1 1.33 71 94.67

chamber comm. 1 1.33 72 96.00

newspaper 1 1.33 73 97.33

radio 1 1.33 74 98.67

Q3) When a patient calls after hours, does the call event get included in the medical record?

Q3 Frequency Percent CumulativeFrequency Cumulative Percent

Yes 228 50.33 228 50.33

No 218 48.12 446 98.45

Don't know 7 1.55 453 100.00

Q4) What happens when patients call the office after hours?

Q4 Frequency Percent CumulativeFrequency CumulativePercent

Answering machine where patients leave messages 211 48.06 211 48.06

Answering service 165 37.59 376 85.65

Clinical triage service (example: nurse hotline) 52 11.85 428 97.49 Direct contact with on-call professional 10 2.28 438 99.77

Other 1 0.23 439 100.00

Q4 Other Responses Frequency Percent CumulativeFrequency CumulativePercent

Directions on machine to go to ER for emergency 1 100.00 1 100.00

Q5) What happens when a patient reaches the

answering machine? Check all that apply. Frequency Percent UtilizationRate

Leave message with office, instructed to go to ER if

urgent 155 43.42 73.81

Instructed to call another number to contact

answering service 62 17.37 29.52

Leave message to be monitored by clinic personnel

every __ hour 1 0.28 0.48

Messages are reviewed in the morning 139 38.94 66.19

Q6) What happens when a patient reaches an

answering service? Check all that apply. Frequency Percent UtilizationRate

Leaves message with office in the morning, instructed

Q6 Other Responses Frequency Percent CumulativeFrequency CumulativePercent

INSTRUCTS TO ER IF URGENT, ALL OTHER CALLS ARE

DIRECTED TO THE MD ON CALL 2 5.41 2 5.41 AFTER HOURS MESSAGE GIVES PATIENT PROVIDER'S

CELL PHONE. PROVIDERS ROTATE ON CALL DUTY 1 2.70 3 8.11 Answering service then pages clinic triage service 3 8.11 6 16.22

CAN ELECT TO SPEAK WITH ON-CALL NURSE 1 2.70 7 18.92

CLINICAL STAFF ANSWERS AND ADVISES PATIENT 1 2.70 8 21.62

CLINICAL STAFF ANSWERS TO ADVISE PATIENT 2 5.41 10 27.03

DEPENDS ON THE SITUATION. IF EMERGENT ON-CALL PROVIDER CALLED; OTHERWISE, INFORMATION FAXED THAT MORNING.

1 2.70 11 29.73

DIRECTED TO CALL OFFICE BACK IN MORN OR GO TO ER

IF EMERGENT 2 5.41 13 35.14 EITHER DIRECTS PT TO CONTACT CLINIC IN THE MORN OR

IF URGENT, PUTS CALL THRU TO ON-CALL MD 2 5.41 15 40.54 INSTRUCTS TO ER IF URGENT, OR THEY PAGE MD ON

CALL AND THE MD CALLS THE PATIENT & NO CERTAIN TIME LIMIT

2 5.41 17 45.95

Kids Care ACH receives calls with instructions 1 2.70 18 48.65

Nurse handles issue or pages physician on call 1 2.70 19 51.35

PAGE PROVIDER 1 2.70 20 54.05

Physician does respond; however, time frame couldn't be

provided. 1 2.70 21 56.76 Professional answers call 1 2.70 22 59.46

The answering service is the hospital so they advise to contact clinic during business hours or go to Urgent care/ER. No messages taken

3 8.11 25 67.57

They do page the on-call professional; however, the

response time is not known. 1 2.70 26 70.27 WILL DIRECT TO ER IF URGENT 1 2.70 27 72.97

pages MD on call 2 5.41 29 78.38

talk to someone 2 5.41 31 83.78

talks to Nurse 3 8.11 34 91.89

Q7) What happens when a patient reaches a triage

service? Check all that apply. Frequency Percent UtilizationRate

Licensed professional reviews clinical problem 48 30.77 92.31

Licensed professional offers treatment advice 45 28.85 86.54

Licensed professional prescribes medication 2 1.28 3.85

Licensed professional contacts office staff for serious

problem 42 26.92 80.77 Licensed professional refers patient to ER without

contacting office staff 14 8.97 26.92

Other 5 3.21 9.62

Q7 Other Responses Frequency Percent CumulativeFrequency CumulativePercent

AT MINIMUM RN WILL BE ON CALL 1 20.00 1 20.00

Clinic forwards phones to local ER. Patients who call are told by ER staff to come to ER if Emergent and if not to contact physician next day during business hours

1 20.00 2 40.00

NURSE TRIAGE/ REFERS TO ER IF URGENT 2 40.00 4 80.00

call goes to on-call physician at hospital 1 20.00 5 100.00

Q8) What happens if office staff answers after-hour

calls? Check all that apply. Frequency Percent UtilizationRate

Each physician covers own patients every

night/weekend 2 16.67 20 Practice personnel share calls 3 25 30

Practice personnel share calls with other community

practices 5 41.67 50

Other 2 16.67 20

Q8 Other Responses Frequency Percent CumulativeFrequency CumulativePercent

DOCTORS ROTATE ON-CALL DUTY 1 50.00 1 50.00

ARKANSAS FOUNDATION FOR MEDICAL CARE • 2011 AFMC 24/7 SURVEY REPORT 31

Verification Tables: Round 1

Q9) What happens when office phone number is dialed?

Q9 Frequency Percent CumulativeFrequency CumulativePercent

Answering machine 44 47.31 44 47.31

Answering service 46 49.46 90 96.77

Medical assistant or health professional answers

the call 1 1.08 91 97.85

Keeps ringing/no answer 2 2.15 93 100.00

Q10) When patients contact the service, does the service contact the practice?

Q10 Frequency Percent CumulativeFrequency Cumulative Percent

Yes 46 100.00 46 100.00

Q11) Does the practice respond within 20 minutes?

Q11 Frequency Percent CumulativeFrequency Cumulative Percent

Yes 46 100.00 46 100.00

Q12) What does the service do if there is no response from the practice? Q12 Frequency Percent Cumulative Frequency CumulativePercent

Keeps calling 24 53.33 24 53.33

Keeps calling or will call pt back 3 6.67 27 60.00 Nurse call pt to answer questions 16 35.56 43 95.56

Service is the practice 2 4.44 45 100.00

Q13) Does the service send a log of the calls to the practice?

Q13 Frequency Percent CumulativeFrequency Cumulative Percent

Yes 5 10.87 5 10.87

No 41 89.13 46 100.00

ARKANSAS FOUNDATION FOR MEDICAL CARE • 2011 AFMC 24/7 SURVEY REPORT 33

Verification Tables: Round 2

Q9) What happens when office phone number is dialed?

Q9 Frequency Percent CumulativeFrequency Cumulative Percent

Answering machine 30 73.17 30 73.17

Answering service 8 19.51 38 92.68

No answer/kept ringing 3 7.32 41 100.00

Q10) When patients contact the service, does the service contact the practice?

Q10 Frequency Percent CumulativeFrequency Cumulative Percent

Yes 5 100.00 5 100.00

Q11) Does the practice respond within 20 minutes?

Q11 Frequency Percent CumulativeFrequency Cumulative Percent

Yes 5 100.00 5 100.00

Q12) What does the service do if there is no response from the practice?

Q12 Frequency Percent CumulativeFrequency Cumulative Percent

Keeps calling 5 100.00 5 100.00

Q13) Does the service send a log of the calls to the practice?

Q13 Frequency Percent CumulativeFrequency Cumulative Percent

No 5 100.00 5 100.00

PROMOTING EXCELLENCE

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HEALTH CARE