Emory Healthcare Case Study

Emory Healthcare was one of the three finalists for the HDI Service Improvement Award in 2015. The finalists were honored, and the winner announced at FUSION 15 in New Orleans.

As the largest healthcare system in Georgia, Emory Healthcare (EHC) encompasses teams of providers at locations across Georgia, including Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopaedics & Spine Hospital, Emory Rehabilitation Hospital, Emory Wesley Woods Center, Emory Saint Joseph's Hospital, Emory Johns Creek Hospital, and Emory Clinic. The Emory Healthcare Network includes 200 primary care and 1,800 specialty care providers. Through our integrated, collaborative care network, we are dedicated to providing the standard of care that our patients expect and deserve.

What was the situation before the launch of the service improvement initiative?

Healthcare is in a constant state of growth and change, and EHC is no exception. EHC has continued to grow and expand, adding new facilities and team members. With this growth, we realized that we needed to do more than just adapt. Some factors and challenges were:

• Our customers’ expectations had changed
• We lacked customer-centric processes
• We weren’t evolving to meet our customers’ needs and expectations
• We had a reactive customer service delivery strategy
• Customers endured long wait times
• New service requests languished as production support always took priority
• Our desktop projects were beyond what could be handled by the current operational set-up

As a result, we faced the following additional challenges that indicated drastic changes to our current approach were needed:

• High open-ticket counts
• Long resolution times for production support issues and service requests
• Strain on resources for project completion
• Customer frustration, leading to complaints and escalations to leadership
• Inability to reduce the number of open tickets and sustain a satisfactory level
• Ticket counts that increased annually while staffing remained the same

Our new approach would need to provide processes and structure that would engage us early in the project and provide direction from a desktop perspective.

What was the improvement strategy?

Our new approach would need to provide processes and structure that would engage us early in the project and provide direction from a desktop perspective. To that end, we focused on streamlining processes to eliminate duplication of effort and improve efficiency, as well as on developing:

• Customer-centric processes
• Customer consulting services
• Improved delivery and installation processes

Which processes and tools had to be implemented, modified, or leveraged to support the improvement strategy?

One of our earliest tasks involved documenting current-state processes and identifying sources of waste and duplication, as well as ways we could leverage our current technology. To that end, we looked into new ways to use our BMC Remedy and Kinetic Request systems. For example, one process we reviewed was how we were procuring and tracking assets. Some phases of the procurement process were manual, had duplication, and were tracked on paper. Now, we follow an automated process that uses templates and customer request forms.

What organizational changes (cultural, structural, or political) had to be implemented or modified to support the improvement strategy?

We made significant changes to our organizational structure in support of this improvement strategy. To alleviate resource constraints, we divided our field services team into two teams: a production support team, which focuses on same-day/next-day resolution of production support issues, and a service request team, which focuses on day-to-day customer requests. To support this new structure, we added three Level IV positions, which we filled by promoting three Level III staff members (ensuring we remained FTE neutral). The Level IV role oversees the computer lab we opened to test images and applications, liaise with the systems team, and serve as a technical escalation point.

We also worked with an authorized trainer to develop an internal customer service academy. Certification is mandatory, and the level each staff member must achieve varies by position (there are four levels of certification: Base, Good, Great, and Expert). Representatives from the service desk, field services, and access management teams attend training together, and this arrangement has enabled them to experience each other’s world by sharing and talking through real-world examples.

What were some of the lessons learned?

• Monitoring: One of toughest lessons learned was that we had to monitor activity very aggressively during the early phases of the go-live. We needed to be able make adjustments rapidly to protect the integrity of the project. Data Collection: Another lesson learned was that we needed to have determined prior to go-live exactly what data we needed to monitor.
• Communication: Since we reset expectations and developed new standard operating procedures, we found that we had to deliver our message repeatedly. While supportive of the new processes, some technicians were falling back into old habits. We realized multiple reminders were needed for new processes to become routine.
• Moved Too Fast: We also realized that, with the excitement of how successful our go-lives were going, we began to move forward with implementing additional changes before allowing sufficient time for the technicians to settle in to the changes we’d already put in place. We had to relax and roll back some of the subsequent changes made after go-live.
• Don’t Compromise: After we implemented our new process at the third location, we realized that we were slightly under the number of resources required to make the plan work. We suspected our expectations may have been a little aggressive, but we were hesitant to ask for additional FTEs since our directive from leadership was that the project had to be FTE neutral. We compromised on this point and regretted that we didn’t at least make the case for an increase. We have since added one FTE.
• Be Creative: In designing our plan, we researched extensively and learned that our approach was unique. This could have discouraged us from the approach that we were convinced was needed to fix our current situation. However, we felt strongly about thinking “out of the box” and moved on with our plans.
• Have Faith and Jump In: We probably spent too much time in the planning phase. With every layer we peeled back, we uncovered more opportunities for improvement. We were accounting for every aspect of our customer experience. We finally had to stop, trust the work we had done, plan our go-live, and jump in.

Has your organization successfully implemented or improved one or more service offerings? Get recognized for your work! Apply for the HDI Service Improvement Award.