Incoming Calls Research Articles

Calling the GP surgery: patient burden, patient satisfaction, and implications for training.

Good communication is central to the effectiveness of GP service provision, as well as to patient satisfaction with surgeries, but very little is known about the actual communication that occurs between patients and surgeries. This study was carried out to examine, for the first time, how receptionists interact with patients on the telephone, to identify features of communication associated with efficacy and patient satisfaction. A qualitative conversation analysis of incoming patient telephone calls, recorded 'for training purposes', in three English GP surgeries. Data were analysed qualitatively to identify effective communication, then coded to establish the relative prevalence of communication types across each surgery. Analysis identified a burden on patients to drive calls forward and achieve service. 'Patient burden' occurred when receptionists failed to offer alternatives to patients whose initial requests could not be met, or to summarise relevant next actions (for example, appointment, call-back, or other query) at the end of calls. Coding revealed that 'patient burden' frequency differed across the services. Increased 'patient burden' was associated with decreased satisfaction on published satisfaction survey scores. Patients in some practices have to push for effective service when calling GP surgeries. Conversation analysis specifies what constitutes (in)effective communication. Findings can then underpin receptionist training and improve patient experience and satisfaction.

From reactive to proactive basic palliative hospital care. Evaluation of one-nurse-based telephone follow-up and bedside consultation to advanced gastrointestinal cancer patients and informal caregivers: A quasi-experimental study

Rationale and aim: Organizational and staff-related barriers need to be overcome in order to integrated early palliative care and develop its supporting infrastructure. We aimed to evaluate the use of a one-nurse-staffed telephone line and bedside consultations on a surgical ward.Method: Advanced gastrointestinal cancer patients and their relatives are offered at diagnosis telephone contact with a nurse with a specialism experience and expertise in the field of palliative care – the contact is lifelong. A proactive holistic approach is taken, including individual needs assessment, guidance, regulation of medication and a tight follow-up. The nurse also acts as a sparring advice partner for colleagues and facilitates complex situations and process. Contacts are described qualitatively in a logbook and the effect on the incidence of hospital admissions and hospital deaths was investigated using a quasi-experimental design with a historical control group. Data were processed using descriptive statistics and Chi-squared (x 2) test.Results: Over 9 month 131 patients and 427 consultations were registred. Outgoing telephone calls to patients, caregivers and professionals (40%). Incoming phone calls (31%) and in-person meeting with patients and families during hospitalization or outpatient visits (29%). Over 15 month intervention and control period the test showed a significant reduction in the short-term admissions of < 2 days, and a significant reduction in the number of patients who died during hospitalization.Conclusion: The telephone follow-up and bedside consultations by one qualified nurse, is an interface that supports continuity and cooperation and could underpine more effective basic palliative care.

How smartphone usage correlates with social anxiety and loneliness

Introduction: Early detection of social anxiety and loneliness might be useful to prevent substantial impairment in personal relationships. Understanding the way people use smartphones can be beneficial for implementing an early detection of social anxiety and loneliness. This paper examines different types of smartphone usage and their relationships with people with different individual levels of social anxiety or loneliness.Methods: A total of 127 Android smartphone volunteers participated in this study, all of which have agreed to install an application (MobileSens) on their smartphones, which can record user’s smartphone usage behaviors and upload the data into the server. They were instructed to complete an online survey, including the Interaction Anxiousness Scale (IAS) and the University of California Los Angeles Loneliness Scale (UCLA-LS). We then separated participants into three groups (high, middle and low) based on their scores of IAS and UCLA-LS, respectively. Finally, we acquired digital records of smartphone usage from MobileSens and examined the differences in 105 types of smartphone usage behaviors between high-score and low-score group of IAS/UCLA-LS.Results: Individuals with different scores on social anxiety or loneliness might use smartphones in different ways. For social anxiety, compared with users in low-score group, users in high-score group had less number of phone calls (incoming and outgoing) (Mann-Whitney U = 282.50∼409.00, p < 0.05), sent and received less number of text messages in the afternoon (Mann-Whitney U = 391.50∼411.50, p < 0.05), used health & fitness apps more frequently (Mann-Whitney U = 493.00, p < 0.05) and used camera apps less frequently (Mann-Whitney U = 472.00, p < 0.05). For loneliness, users in low-score group, users in high-score group had less number of phone calls (incoming and outgoing) (Mann-Whitney U = 305.00∼407.50, p < 0.05) and used following apps more frequently: health & fitness (Mann-Whitney U = 510.00, p < 0.05), system (Mann-Whitney U = 314.00, p < 0.01), phone beautify (Mann-Whitney U = 385.00, p < 0.05), web browser (Mann-Whitney U = 416.00, p < 0.05) and social media (RenRen) (Mann-Whitney >U = 388.50, p < 0.01).Discussion: The results show that individuals with social anxiety or loneliness receive less incoming calls and use healthy applications more frequently, but they do not show differences in outgoing-call-related features. Individuals with higher levels of social anxiety also receive less SMSs and use camera apps less frequently, while lonely individuals tend to use system, beautify, browser and social media (RenRen) apps more frequently.Conclusion: This paper finds that there exists certain correlation among smartphone usage and social anxiety and loneliness. The result may be useful to improve social interaction for those who lack social interaction in daily lives and may be insightful for recognizing individual levels of social anxiety and loneliness through smartphone usage behaviors.

The Vehicle Mix Decision in Emergency Medical Service Systems

We consider the problem of selecting the number of advanced life support (ALS) and basic life support (BLS) ambulances—the vehicle mix—to deploy in an emergency medical service (EMS) system, given a budget constraint. ALS ambulances can treat a wider range of emergencies, whereas BLS ambulances are less expensive to operate. To this end, we develop a framework under which the performance of a system operating under a given vehicle mix can be evaluated. Because the choice of vehicle mix affects how ambulances are dispatched to incoming calls, as well as how they are deployed to base locations, we adopt an optimization-based approach. We construct two models—one a Markov decision process, the other an integer program—to study the problems of dispatching and deployment in a tiered system, respectively. In each case, the objective function value attained by an optimal decision serves as our performance measure. Numerical experiments performed with both models suggest that, under reasonable choices of inputs, a wide range of tiered systems perform comparably to all-ALS fleets.

Going beyond duopoly: Connectivity breakdowns under receiving party pays

We show that the prediction of strategic connectivity breakdowns under a receiving-party-pays system and discrimination between on- and off-net prices does not hold up once more than two mobile networks are considered. Indeed, if there are at least three competing networks and enough utility is obtained from receiving calls, no strategic connectivity breakdowns occur. Private negotiations over access charges then achieve the efficient outcome. Bill & keep (zero access charges) and free outgoing and incoming calls are efficient if and only marginal costs of calls are zero.

Прогнозування навантаження та планування розкладу роботи операторів контактного центру

A non-classical method for contact center load forecasting as well as methods (Erlang C, imitation modelling) to count the necessary amount of operators have been applied. The task to predict the volume of contact center incoming calls for a certain month and also to calculate the necessary number of operators have been set and solved. Conclusions about the model’s forecast quality and precision have been presented.

Impact of incoming phone calls on oncology departments in oral therapies era: a large national prospective survey.

e18210Background: Oral therapies, and an increase of patient involvement have shifted the follow-up of patients with cancer from hospital to home. As a consequence, the number of incoming phone cal...

Using an emergency response infrastructure to help women who experience gender-based violence in Gujarat, India.

ProblemMany women who experience gender-based violence may never seek any formal help because they do not feel safe or confident that they will receive help if they try.ApproachA public–private-academic partnership in Gujarat, India, established a toll-free telephone helpline – called 181 Abhayam – for women experiencing gender-based violence. The partnership used existing emergency response service infrastructure to link women to phone counselling, nongovernmental organizations (NGOs) and government programmes.Local settingIn India, the lifetime prevalence of gender-based violence is 37.2%, but less than 1% of women will ever seek help beyond their family or friends. Before implementation of the helpline, there were no toll-free helplines or centralized coordinating systems for government programmes, NGOs and emergency response services.Relevant changesIn February 2014, the helpline was launched across Gujarat. In the first 10 months, the helpline assisted 9767 individuals, of which 8654 identified themselves as women. Of all calls, 79% (7694) required an intervention by phone or in person on the day they called and 43% (4190) of calls were by or for women experiencing violence.Lessons learntDespite previous data that showed women experiencing gender-based violence rarely sought help from formal sources, women in Gujarat did use the helpline for concerns across the spectrum of gender-based violence. However, for evaluating the impact of the helpline, the operational definitions of concern categories need to be further clarified. The initial triage system for incoming calls was advantageous for handling high call volumes, but may have contributed to dropped calls.

Patient burden during appointment-making telephone calls to GP practices

ObjectiveThis study addresses, for the first time, the effectiveness of receptionists handling incoming calls from patients to access General Practice services. MethodsIt is a large-scale qualitative study of three services in the UK. Using conversation analysis, we identified the issue of ‘patient burden’, which we defined based on the trouble patients display pursuing service. We quantified instances of ‘patient burden’ using a coding scheme. ResultsWe demonstrate how ‘patient burden’ unfolds in two phases of the telephone calls: (i) following an initial rejection of a patient’s request; and (ii) following a receptionist’s initiation of call closing. Our quantitative analysis shows that the three GP services differ in the frequency of ‘patient burden’ and reveals a correlation between the proportion of ‘patient burden’ and independent national satisfaction scores for these surgeries. ConclusionUnlike post-hoc surveys, our analysis of live calls identifies the communicative practices which may constitute patient (dis)satisfaction. Practice implicationsThrough establishing what receptionists handle well or less well in encounters with patients, we propose ways of improving such encounters through training or other forms of intervention.

Abstract NS11: Using a Template in the Electronic Medical Record to Improve Communication Between Emergency Medical Services and the Emergency Department for Acute Stroke

Background: In the advent of electronic medical records (EMR), emergency departments (ED) are challenged to include communication with inbound Emergency Medical Services (EMS) within the medical record. Using standardized documentation to guide and capture this critical communication may impact early activation of the stroke team and improve ‘Door to CT’ times. Starting with the “Pre-Notification” measure in Get With the Guidelines (GWTG), our team set out to improve this measure, then evaluate its impact on early stroke team activation and imaging timelines. Purpose: To utilize a standardized template in the EMR to improve the GWTG Pre-Notification measure by 30% and evaluate its impact on early stroke team activation and imaging. Methods: Initially, the team agreed that clear criteria for stroke team activation were needed. Once established, a standardized template was designed within the EMR. This included point of care glucose, neurological symptoms, cardiac rhythm, time ‘last known well’, and establishment of IV access/labs drawn. The communication nurses, designated to receive incoming EMS calls, were instructed on the use of this standardized template to guide and record communication for incoming stroke patients. Education and feedback were also provided to EMS providers so that they could anticipate required information and ensure that appropriate care occurred in the pre-hospital setting. Results: The “Pre-Notification Measure” improved from 29%-77%, early stroke team activation improved from 45% - 73%, and median ‘Door to CT’ time improved from 25 minutes - 18 minutes. (Figure). Conclusions: Using a standardized template in the EMR improves expectations of care for the ED and EMS providers. This translates into better scores for the GWTG “Pre-Notification” measure, as well early stroke team activation and imaging timelines.

Topic mining for call centers based on A‐LDA and distributed computing

SummaryEarly work on call centers focused on opinion collection, and service acceptance used manual entry to record text information for incoming calls and to count various types of calls. With the development of text mining technologies, it is possible for call centers to become information providers. Although traditional text mining methods have been well studied, no algorithm has been designed specifically for call center data, which contains structured information about the call center in addition to plain text. A telephone call usually has several properties such as caller number, call time, and so on. Aiming at the data characteristics of call centers, in this paper, we propose an improved latent Dirichlet allocation (LDA) model called A‐LDA, which includes information from external‐related attributes and is suitable for building topic mining models for call centers. We present a Gibbs sampling‐distributed computing implementation for our model's inferences and use datasets from China Central Television telephone call center to perform an experiment on topic detection. The results show that A‐LDA, which uses external correlation properties, has a lower perplexity value and a better generalization performance than the traditional LDA method and can find topics associated with values contained by the external attributes. Copyright © 2016 John Wiley &amp; Sons, Ltd.

Network externalities in telecommunication industry: An analysis of Serbian market

This paper deals with network competition and provides empirical analysis of market concentration, network and call externalities, access pricing, price discrimination and switching costs in Serbian mobile phone telecommunications market. It is shown that network externalities governed the expansion of this market until 2008. Upon entry of VIP incumbents didn't engage in predatory behaviour towards entrant aiming to benefit from locked- in users. The policy of mobile phone number portability reduced on-net prices and substantially increased consumer's surplus. In contrast to some previous research, this policy was pro-competitive in Serbia. We have also determined that users of the network with the largest market share benefit the most from call externalities. Finally, one network does not price discriminate between outgoing and incoming roaming calls, which implies that users of this network have higher level pecuniary externalities in roaming compared to users of price discriminating networks.

Forecasting of Intraday Interval Arrivals for Small and Medium Sized Call Centers with Emergencies

In order to improve service level and responsiveness, many market-oriented enterprises gradually pay attention to the role of call centers. Call center supported by digital technology can provide data to help these enterprises in terms of knowledge mining, data analysis, and even intelligent manufacturing. This paper focuses on the forecast method of call center, presenting a two-sector model. The upper model proposed is used to identify the characteristics of drastic incoming calls change based on recent and historical data, and the bottom model proposed consists of several prediction models that process different data characteristics.

High Ringxiety: Attachment Anxiety Predicts Experiences of Phantom Cell Phone Ringing.

Mobile cell phone users have reported experiencing ringing and/or vibrations associated with incoming calls and messages, only to find that no call or message had actually registered. We believe this phenomenon can be understood as a human signal detection issue, with potentially important influences from psychological attributes. We hypothesized that individuals higher in attachment anxiety would report more frequent phantom cell phone experiences, whereas individuals higher in attachment avoidance would report less frequent experiences. If these experiences are primarily psychologically related to attributes of interpersonal relationships, associations with attachment style should be stronger than for general sensation seeking. We also predicted that certain contexts would interact with attachment style to increase or decrease the likelihood of experiencing phantom cell phone calls and messages. Attachment anxiety directly predicted the frequency of phantom ringing and notification experiences, whereas attachment avoidance and sensation seeking did not directly predict frequency. Attachment anxiety and attachment avoidance interacted with contextual factors (expectations for a call or message and concerned about an issue that one may be contacted about) in the expected directions for predicting phantom cell phone experiences.

Algorithmic computation of steady-state probabilities in an almost observable GI/M/c queue with or without vacations under state dependent balking and reneging

We consider an almost observable GI/M/c/N queue with customer impatience with or without multiple synchronous vacations under state-dependent balking. Upon arriving, a customer joins or refuses to join the system based on certain state dependent joining/balking probabilities. Once an arriving customer joins the system and finds all the servers busy, it initiates an exponentially distributed impatience timer with random duration T. An equilibrium balking strategy is discussed for constant balking as a special case of state-dependent balking. In the constant balking case, the waiting time of a customer in a queueing system has been associated with a linear cost-reward structure for estimating the net benefit if a customer chooses to participate in the system. A steady-state system of equations is obtained using the supplementary variable technique. After that, a recursive algorithm is proposed to obtain the stationary system-length distribution at pre-arrival and arbitrary epochs using those steady-state equations, from which the mean system sojourn time, the average reneging rate and the average balking rate are derived. Finally, we produce numerical results relating to system performance and its net benefit when investigated for different model parameters. The proposed model has applications in the modeling of balking and impatient behavior of incoming calls in a call center, multi-core computing, multi-path routing in delay sensitive communications networks.

A novel hybrid method for improving ambulance dispatching response time through a simulation study

Response time is the most important factor in evaluating the performance of various Emergency Medical Services (EMS). In this paper, a novel hybrid method has been proposed to improve response time for ambulance dispatching. The proposed approach uses a linear hybrid metric based on network centrality measures, nearest neighbor method and first-in first-out (FIFO) policy. Other important parameters in ambulance dispatching such as the operating environment, rate of incoming emergency calls, available resources, hospitalization probability of the patients as well as distances and locations of units are all part of information used in this proposed approach. In line with the traditional metrics used in previous works, we have adopted a linear combined metric which is adjusted according to environment parameters. Results of extensive simulation experiments show reductions in response time by as much as 42% as compared to previous methods.

Is the only poll that counts the one on Election Day?

Is the only poll that counts the one on Election Day?

Cost Analysis of a Hybrid-Movement-Based and Time-Based Location Update Scheme in Cellular Networks

A movement-based location update (MBLU) scheme is effective and has low operation complexity. On the other hand, cellular networks use periodic LUs that are intrinsically time-based LUs (TBLUs) to detect the presence of a user equipment (UE) to avoid wasting network resources to deliver incoming calls to an abnormally detached UE. When implemented in a cellular network, the MBLU scheme must incorporate TBLUs to detect the UE presence. Thus, a hybrid-movement-based and time-based LU (HMTBLU) scheme arises naturally. Under the HMTBLU scheme, an LU occurs either when the movement threshold for MBLUs is reached or when the time threshold for TBLUs is reached. In this paper, we develop an embedded Markov chain approach to calculate the signaling cost of the HMTBLU scheme. We derive analytical formulas for the signaling cost and formulas useful for designing an optimal paging scheme. The accuracy of these formulas is validated through simulation. Based on these formulas, we conduct a numerical study to investigate the influence of various parameters on the signaling cost. The derived formulas can guide the implementation of the HMTBLU scheme in cellular networks, including Long-Term Evolution (LTE). Moreover, the developed mathematical approach can be applied to studying other LU schemes such as the LU scheme used in LTE.

Staff management in Paediatric Primary care setting

In the last 6-7 years there has been a progressive increase in the use of nurses or secretaries in Paediatric Primary care setting. Regional incentives (few) and the rising (remarkable) of the workload and patients’ requests, convinced about the 40% of the italian Family Paediatricians (FP) to hire new staff. In the 70% of cases the employers were organized in working group in one private practice that, thanks to the costs’ sharing, frequently had nurses in their staff (the data represent the situation at the end of 2013 and were obtained asking directly FP's professional organizations). Solo Paediatricians and Associated Paediatricians (that work in several private practices in coordination each other), on the other hand, hired more frequently secretaries with a working time generally reduced if compared to working groups’ colleagues. Economic factors (the fear to be unable to fulfill the expenses related to hiring) and those concerning organization and management (the not perfect knowledge of how best to use the staff) are the main causes that prevent most of Paediatricians to employ [1]. Who decided to use co-workers, did it to delegate certain duties, to filter patients’ requirements, to share work experience [1]. Secretaries can officiated the following tasks: sorting incoming calls, appointments, advise on admission to medical consultation, set up patient's recording (1st consultation), illustration and delivery of the services charter, delivery questionnaires, registration of diagnostic services, recurrent prescriptions, preparation of medical certificates, patients’ active call for programmed medical examinations, billing, payment deadlines and commitments, check of the monthly payment slips obtained by the Health Service, registration deadlines of drugs and medical devices, suppliers list, mantainance men and contracts list, health servicices summaries, statistics, chart statistic diagrams, waiting room monitoring (games, cartoons, magazines, books, etc.), appointment calendar update. Nurses can perform the following functions: Telephone Triage; Telephone advices based on defined protocols that are recorded in the electronic patient health card, auxological recordings, performing diagnostic tests and screening (urine examination, rapid Strep test, RCP, Blood Count, Prick Test, oximetry, spirometry, eye test, Lang test, Boel test, Plicometry, etc.), infant care, clinical and epidemiological research, health education messages in the waiting room, drugs and medical devices deadlines monitoring, provisions supervision, medical equipment efficiency preservation, health care protocols update and recording, check office's e-mails. In the near future the decrease of FP's number, the need to take care of a larger number of patients and to organize work in some way of collaboration, will push more and more colleagues to hire staff.

Prediction of telephone calls load using Echo State Network with exogenous variables

We approach the problem of forecasting the load of incoming calls in a cell of a mobile network using Echo State Networks. With respect to previous approaches to the problem, we consider the inclusion of additional telephone records regarding the activity registered in the cell as exogenous variables, by investigating their usefulness in the forecasting task. Additionally, we analyze different methodologies for training the readout of the network, including two novel variants, namely ν-SVR and an elastic net penalty. Finally, we employ a genetic algorithm for both the tasks of tuning the parameters of the system and for selecting the optimal subset of most informative additional time-series to be considered as external inputs in the forecasting problem. We compare the performances with standard prediction models and we evaluate the results according to the specific properties of the considered time-series.