Development of one generic call centre for unplanned health needs. A qualitative study

Abstract

Introduction: A range of different telephone based services exists to serve the public with some sort of unplanned health needs (acute need). These are organized as call centres and offer services like medical emergency, response to automatic warning aids and more social services. However, even if it is valuable with many different services, it is not likely that the public know of all these services and furthermore they are resource demanding to operate. In Central Norway a group of municipalities together with a city have decided to develop one generic call centre with one phone number to offer better services and solve more enquirers by phone. The aim of this study was to study health professionals and leaders' attitudes towards one generic call centre and what they saw as the challenges and opportunities to make it work. Methods: This was a qualitative study with observations of meetings and qualitative group and individual interviews with 17 employees (seven leaders) who have been involved in the development process and who worked in the affected services; primary care medical emergency service, support for people who have automatic warning aids and an emergency service for people with abuse or mental health problems. The generic call center is to open in autumn 2015 and the data have been collected from autumn 2013. Results: It was readily observed that the views on the generic call centre were dependent on which services the informants came from. Those from medical emergency were clearly more skeptical, especially due having to move from their current location in a hospital and not having direct patient contact as the generic call centre would be located separate from the emergency room. Several expressed a fear that the area to cover for each operator would be too extensive in a generic call centre and that few people would want to work there. This difference was also evident in whether or not they thought the generic call centre would lead to solve more enquirers by phone (e.g. less visits to the emergency room), with those working in medical emergency saying most strongly that this was not likely to happen as the patients which 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117108– http://www.ijic.org/ was to see the doctor. To increase the likelihood of less need for direct face to face contacts, a public media campaign was suggested and that the technical system improved to make it easier to get through on telephone. The informants had different views on and experiences with the use of support systems and varied in their view on the usefulness of such systems. Some had experienced that such system overtriaged (indicated that more patients needed to see a doctor) while other said it was an important tool for quality assurance and safe practice. The informants had different views on what type of competencies that were needed especially regarding formal education. They agreed on the need for all operators to have good communication skills, being able to multitask, to handle the support systems and being able to keep calm in stressful situations. Discussions: During the process, those involved have become more positive towards the establishment of one generic call centre. This was especially observed after executive decisions concerning the more concrete aspects of the generic call centre were taken. Conclusions: Getting a workable generic call centres was seen as challenging. To populate a generic call centre with personnel from different services one has to take into account the difference in culture. Lessons learned: (from the point of view of research development) Having a researcher following the process has proven useful due to the findings being feed back into the process highlighting the areas with most tension. Limitations: This study concerns the earl phase of the process. Different results can be expected closer to and after the opening of the generic call centre. Suggestions for future research: More knowledge is needed on the professional skills needed to work in a generic call centre.