Improving the New Patient Experience

Using Design Thinking to refine a multi-touchpoint process

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“Unfortunately, it’s leukemia…”

I spent 2 years working at Dana Farber Cancer Institute as a New Patient Coordinator for the Leukemia and Bone Marrow Transplant team, and this was the dreadful sentence that led to each new patient conversation. In such an emotional moment, all I could do was be an empathetic voice on the other line ready to help in any way possible.

All though there are many steps involved in the new patient process, I wanted to focus this case study on the importance of the first point of contact between the prospective patient and the New Patient Coordinator (NPC).

Develop a process that reduces the stress for patients and allows the NPC to efficiently retrieve the important medical information needed to prepare for the in-person visit.

Solution

Challenge

To create and refine several processes that focus on making the New Patient Visit experience seamless and efficient for patients as they navigate through the news of their diagnosis.

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Customer Service is Key

Providing excellent customer service is the utmost importance here. It is a vital part of the NPCs job to make the patient feel that from the moment they get us on the line we are handling their needs. Instead of creating one overall persona, I believe a persona group reflects the truth of our patient pool.

The New Patient Call

What: A patients’ first time coming to see one of our providers for care or a second opinion on their diagnosis.

Why: The call is the first point of contact between the patient and the hospital staff. As an NPC, you want to set the tone of the appointment and let the patient know that we are here to handle everything needed for their visit. It's the idea of ‘set it and forget it’, in this case, make the appointment and show up.

We work behind the scenes to prepare all necessary paperwork and obtain medical information before the patient arrives.

2 New Patient Coordinators

16 MDs on the team

100+ Patients weekly

1-4 Days Median Wait Time

Figuring out a process

Enable to make the most of the New Patient call, I had to know exactly what information I needed from the patient. The department had a form to use during the calls but I quickly realized that it was too generic and didn’t ask all the right questions.

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Due to hospital policy, I can not display what the form looked like but are forms I found online that look similar.  

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I spent about 3 months observing the process and asking questions to bypass the assumptions and find applicable solutions.

Observing Patients

With the emotional caliber of the diagnosis it is easy for patients/caller to accidentally give incorrect information, it happened a lot. As a result, I was sent on a wild goose chase for information that might not exist. 

Patients didn’t want to speak to a robot. They needed a human that could empathize and understand what they were going through.

Through observation and continuous iteration on the way I spoke to patients, I’ve concluded asking questions in a conversational manner versus a formal approach puts patients’ minds at ease quicker.

Questioning the Doctors

I spent time speaking to various doctors and nurses on what type of information they needed most for this visit.

From the insight gathered, I worked backwards to come up with the questions I needed to ask the patients and callers I spoke with.

Most frequently heard answers were:

1. Notes from the original diagnosis?

2. Name of referring and diagnosing MD?

3. What test were done?

4. Did they take pathology samples?

5. Where were pathology materials sent?

The New Patient Call Form

Since I couldn’t officially change the form, once each form was printed, I added new sections and labels to fit the natural flow of my conversation. I created this form below to reflect the ways I reconstructed the old one into something new. Below I’ve gone to further explain why each section and change was done and the impact it had on our process.

Form DFCI

Ability to record who was calling. Sometimes MD offices and family members call on behalf of the patient.

Added this to show that we respect gender identity.

Also to make everyone feel comfortable while still getting the medical information necessary

Makes it easier to speak with a nurse who knows the patient vs just a random nurse

Clarifying if the referring MD is the same as the MD that diagnosed them. Many times we found out too late that these were not the same providers and patients sometimes fail to mention this.

Having Insurance next gives you a chance to load your system: Open the nurses calendar, MD calendar in EPIC, and Lab Calendar to see appt times available.

Its important to see if the patient has valid insurance that the hospital takes.  

An additional place to confirm the appt details for your paper records

Used the color yellow to remind you to be remind NPCs to be cheerful and hopeful on the phone

Place to record patient medical record number

With this new structure, we were able to ask more targeted questions which set a strong foundation for medical record retrieval and appointment scheduling.  

If not valid then you know not to set an appointment date just yet and transfer the call to registration so they can help them obtain the correct insurance before proceeding  

66 %

25 %

RESULTS

As soon as 5 weeks after implementing this change, collectively we saw the following changes:

50 %

increase in the number of patients helped per week

decrease in times patient was called for additional info

decrease of misdiagnosis & other errors per week

decrease in time it took to retrieve medical materials

30 %

REFLECTION

Using Design Thinking, I was able to  identify alternative strategies and solutions for improving the New Patient Experience.When speaking with patients, reframing  my questions in a human-centric way improved the overall encounter and helped get more correct information the first time around. By questioning the way things were being done and listening to patients and providers, I developed a deeper understanding for how I could improve the NPC role and patient experience with something as simple as restructuring a form.