Health Call Center Quality Assurance

The industry's most comprehensive quality assurance program

At SironaHealth, our approach to providing telehealth and contact center services revolves around one core strategy — if you focus on the quality of the caller experience, you will build an efficient process that ensures patient safety and drives satisfaction.  

Our goal is to create a quality improvement process so efficient and effective that it allows us to identify and act on negative indicators before they become quality issues. 

Meeting quality benchmarks through URAC accreditation

URAC provides us with an important external evaluation of our patient service and organization performance. As part of our URAC accreditation, we guarantee to meet specific performance metrics, including: 

For a complete summary of URAC's Health Call Center Accreditation Standards, click here.

Focusing on the problems that impact patient safety

SironaHealth utilizes several approaches to monitor practice and proficiency within its health call center environment — including silent monitoring of calls, auditing aggregate data looking for trends or changes in call-handling metrics, and reviewing process documentation.

But when your health call center conducts millions of calls per year, how do you choose which calls to audit? If your answer was to conduct "random sampling," you'd be wrong. 

Random sampling may be acceptable in traditional call centers, but it has no place in the clinical environment. What you need is a process to trend, identify, and intervene on quality issues before they have a chance to negatively impact patient safety.

Introducing Human Intensive Process ControlTM

We use the science of applied statistical analysis to profile decisions made by our clinical and non-clinical staff. This approach allows us to profile our team and identify "outliers", or team members whose metrics are outside of normal control limits for a given process.

Rather than taking a random sampling of calls, our quality team can conduct focused audits on team members exhibiting non-conforming trends.

SironaHealth's Human Intensive Process Control

Our Human Intensive Process Control statistical methodology characterizes processes that are heavily influenced by decision-making. Our analysis looks at clinical behavior among telehealth teams — clinicians who talk callers through presenting symptoms using both physician authored guidelines and clinical judgment to determine the next level of care. 

By using Human Intensive Process Control, we are able to closely monitor and manage:

  • Risk Bias - is the nurse exhibiting inappropriate conservative or risky behavior when selecting a disposition during the triage process?
  • Guideline Bias - is the nurse using new or updated clinical guidelines appropriately or do they require re-training?
  • Process Compliance - is the nurse following the appropriate call process?

This approach to quality is extremely accurate in identifying safety and quality issues, allowing us to act quickly and avoid situations that could negatively impact patient safety.