August 27, 2004

VMG improves physician referral process

Featured Image

VMG physician referral center triage nurses Carol A. Wallace, R.N., and Terrilyn Vickers, right, R.N., each have 18 years’ experience in telephone triage. Photo by Dana Johnson

VMG improves physician referral process

Vanderbilt Medical Group has established a physician referral center as a single contact point for community referring physicians. The center opened in mid June with the motto, “One number, one call, all specialties.” The center’s number is 1-800-288-5000.

The new center will help both to improve access for community referring physicians and to achieve VUMC business goals for increased patient volume, said C. Wright Pinson, M.D., chief medical officer and associate vice chancellor for Clinical Affairs.

“A lot of people complain that they can’t get access to care at Vanderbilt,” Pinson said. “I’m not thrilled by the idea that people see this place as difficult, and I want to help fix that. We’re in a service business so I see providing good service as important.”

VMG practice groups can choose how heavily to rely on the services of the center, including the option of centralized appointment scheduling by the center’s highly experienced triage nurses, said Sustin D. Anderson, director of outpatient registration, guest services and call centers.

To date, about 40 percent of VMG practice groups have opened up their electronic scheduling systems and invited the center’s triage nurses to book appointments for their doctors; Anderson expects more VMG clinics eventually to take advantage of this service.

As each call comes in to the center, coordinators obtain the basic information needed to follow up to ensure that the referring doctor’s requests are met.

• If the referring doctor wants his patient seen by one of the VMG services for which the physician referral center provides scheduling, then the coordinator passes the call to one of the center’s triage nurses and the appointment is booked.

• If the referring doctor wants his patient seen by one of the VMG services for which the center has not yet been invited to provide scheduling, then the coordinator calls the clinic, passes on the basic information received from the caller, and switches the caller through to complete scheduling.

• If the referring physician wants to transfer a patient to Vanderbilt University Hospital, the call is passed through to nurses in the VUH patient transfer center.

Intensive call follow-up by the center will make life easier for referring doctors. For each call for an appointment that the center passes to a scheduler in the clinics, the center’s staff check the scheduling system to make sure the appointment gets booked. If there appears to be a delay in booking an appointment, the center contacts the clinic to find the cause of the delay, then places a call to update the referring physician.

If, in trying to connect a referring doctor’s office with a clinic scheduler, the coordinator and the caller are knocked into a phone queue for more than a minute or two, the coordinator will offer to have a clinic scheduler call the referring office within an hour. Again, the center will follow up to make sure the connection was made and the request was handled.

Pinson said Vanderbilt will never be able to match capacity to demand perfectly for all of the nearly 100 service areas within VMG.

“On the other hand, we can manage demand and supply through an intermediate appointment process; for example, if certain services are booked several months in advance and are unable to accommodate new requests for appointments, that’s a dead end, a failure to provide service, and in such instances it’s conceivable that we may begin referring patients to community groups.

“We’re not trying to mandate a centralized appointment-making process for all of VMG,” Pinson added. “If services can do it for themselves, great. However, if it becomes apparent that a given service can’t do it, we may ask to do it for them.”

Pinson also said the referral center may eventually expand to handle calls from patients seeking appointments at VMG.

The physician referral line will be promoted in the upcoming edition of the VUMC Physician Referral Directory, and VUMC’s community physician liaisons have begun to put out the word about the referral line.