Delivering Better Service, Faster

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Marie Curie Cancer Care slashed its referral time by 76 percent, increasing patient visits and improving customer service.

Keeping pace with change is no easy task for any business. Marie Curie Cancer Care, however, was determined to not only keep pace with the changes affecting its industry, but also to ensure customer satisfaction along the way.

An increasing number of patients with terminal illness are opting to die at home, surrounded by their loved ones in an environment that's familiar to them and where they feel safe. This trend has resulted in a spike in requests for palliative care professionals to visit these patients at home, giving them the needed care and treatment to ensure that they are comfortable during their last hours. Marie Curie Cancer Care, a British charity that has been offering this service for more than 60 years, experienced a 17 percent increase in the number of at-home visits its nurses made over the past three years. During the 2010-2011 fiscal year its 2,000 nurses provided 1.2 million hours of care to more than 23,000 patients.

The organization's management was well-aware that the aging population and ever-changing public health system in the UK is likely to further increase requests for in-home palliative care. However, Marie Curie Cancer Care was struggling to quickly match nurses to patients, with each referral taking an average of 25 minutes to complete, mostly because it had outgrown its IT system. Management knew it had to quickly and effectively change the organization's referral system to keep pace with the current and future increases in demand for end-of-life care in patients' chosen environment. The organization needed to slash the time and effort it takes its Wales-based contact center employees to match a patient with a nurse who is not only available during the needed time, but also has the necessary skills set to care for a particular patient. "We were struggling to keep up with the demand," says Jen Penfound, the charitable organization's head of information technology.

The fact that the charity caters for the four countries that comprise the UK-England, Wales, Scotland, and Northern Ireland-further complicated matters, since contact center agents do not have the local knowledge to ascertain whether a nurse could get to her patient within a particular time frame. For example, in Scotland the distance between two destinations could be 15 miles as the crow flies, but the nurse has to make a 45-mile journey because of obstructions like a river.

Timeliness is especially important for regions that offer overnight rapid emergency response for patients who are in crisis. "Our aim is to always keep the patient at home," Penfound says. "The last thing anyone wants is for a patient to go into crisis in the last 48 hours and have to be rushed to hospital." This meant that the contact center is under even more pressure to find the right nurse for the job and ensure that the patient receives the needed care in the shortest time possible. "We don't get a second chance in delivering end-of-life care," she adds.

This left Marie Curie Cancer Care with two options: It could either find a more effective way to match nurses and patients, or increase its contact center staff to deal with the rising number of referrals.

The organization determine that the best solution would be to find a new IT system that could accomplish three primary objectives: scale to its growing patient base; provide the exact mileage between the nurse's location and the patient's home, giving a clearer indication of how long it would take for the caregiver to get there; and match the right nurse to each patient. Referrals become more complicated when the patient needs a nurse with a particular skill, for example, in handling a syringe driver that injects medication over an established period of time or performing blood transfusions. Under the previous system, nurses would have colored stars next to their names indicating their skills, so call center agents were spending a long time looking through the roster of nurses to find the right match.

Meeting these objectives would improve the experience for agents, nurses, and patients, as well as hospital or doctors' office staff calling in for referrals. So last year Marie Curie Cancer Care implemented Sword Ciboodle's Patient Connect system, allowing the organization to completely automate its referral system. This led to an increase in patient visits by about 30 percent and a 76 percent reduction in referral time, from 25 minutes or more down to a mere six minutes.

The charity experienced three-pronged success. First, busy district nurses who called in to refer a patient were no longer being kept on the phone for almost 30 minutes until the contact center agent found a nurse who matched their patient's requirements. In fact, when Marie Curie Cancer Care had just started using the new system, a district nurse who called in to order a number of visits for a patient voiced concern that a referral was not done properly because it had taken such a short time. Penfound says the nurse in question was aware that she had made the call close to the contact center's closing time and the agent was likely anxious to go home. "She said it was impossible for the agent to have inputted the information and ordered the visits in such a short time. In fact everything was in order and the nurse could hardly believe it, bearing in mind how long it would have taken beforehand," Penfound says.

Patients and their families are benefitting from the organization's ability to match nurses to their needs in a shorter period of time, thus allowing for quicker visits when these are needed. The charity increased overall visits by a third and nurses have reported a 20 percent improvement in customer satisfaction, especially because they are now able to focus on the patient rather than worry how long it would get them to get to the residence.

Moreover, because the organization doesn't need to expand its contact center it can use the resources to provide additional patient-centric services. Penfound says the new system also supports an increase in at-home care requests, especially through self-referrals, which are expected to increase as Britain's health system moves towards giving patients more control of their treatment. "We can grow our services without having to grow our administrative overheads," she says.

With a new strategy in place, Marie Curie Cancer Care is able to focus on its most important job: delivering optimal care to terminal patients who want to die at their home and supporting the family members who are with them.