nascod-contact usa conference presentation sharing final
TRANSCRIPT
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Artful balance: How technology can help you manage the needs of consumers, funders, and workers
NASCOD/CONTACT USA Conference 2015Friday, October 23, 2015Detroit, Michigan
Marshall EllisVice President, Crisis & Behavioral Health Technologies, MHA-NYC/Link2Health Solutions, Inc.
Anitha Iyer, Ph.D.Clinical Director, Here2Help ConnectMHA-NYC
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Overview
•About Us
•Here2Help Connect (circa 2012)
•Adopting and Managing to Standard Performance Metrics
•Technology Enhancement Project
•Here2Help Connect (Now)
•Establishing National Benchmarks for KPIs
•Questions
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About MHA-NYC
MHA-NYC is a leader in developing innovative approaches to address mental health needs
A nonprofit organization with a three-part mission of: ◦ Services
◦ Advocacy
◦ Education
Rooted in New York City, with a growing demand for services well beyond our borders.
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About Here2Help Connect
Here2Help Connect is a leader in behavioral health call center services with more than 15 years of experience providing crisis intervention and access services.
Our highly trained staff and advanced call center technology allow us to provide customized behavioral health call center solutions for a wide range of public and private partners.
Here2Help Connect’s services are rooted in clinical excellence. We continuously monitor clinical outcomes and our staff actively participate in the development of best practices and research-based clinical interventions, including the suicide risk assessment standards and imminent risk policies used by the SAMHSA-fund National Suicide Prevention Lifeline.
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Our Team
Here2Help Connect launches new NYS HOPEline texting service--May 2015. The Here2Help Connect/MHA-NYC team with (seated l-r) Advocate Tatiana Green, NYS OASAS Commissioner Arlene González Sánchez, NYS Assemblymember Linda Rosenthal, and MHA-NYC President & CEO Giselle Stolper.
Dynamic and supportive team of professionals
Strong Commitment to Excellence and Continuous Quality Improvement
Multi-lingual (English; Spanish; Chinese)
Full-time; part-time; interns; remote workers
Range of experience levels and backgrounds Social Work
Psychology
Creative Arts Therapy
Mental Health Counseling
Public Health
Graduate Student Interns
Call Center & Business Professionals
And more!
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Our Public Service Programs
Here2Help Connect partners with NYS OASAS, NYC DOHMH, and SAMHSA to provide several free and confidential public service hotline programs.
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Our Contracted Programs & Services
Here2Help Connect provides services under contract for a number of healthcare and corporate partners in New York and nationwide.
These healthcare partners work with us because of our expertise in effectively serving the behavioral health needs of a wide range of populations.
Contracted Partners include:Health insurance/managed care companies
Mental health clinics
Corporate partners
Federally funded research projects
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Here2Help Connect (circa 2012)
•Hired great clinicians
•Staff here for the right reasons and with great ideas for helping clients
•Offered supportive work environment
•Provided great content & protocol training
Most Satisfying
Things About
Working Here (Jan 2012 Counselor Survey)
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Workforce Management (circa 2012) •Capacity Planning• Flat fee, multi-year contracts meant: Capacity Plan = Approved Staff Budget• Around 35 agent FTEs and 8 MSW student interns• Mostly MSW social workers
•Forecasting• Manual forecasting via Excel files so large we couldn’t email them• Based on actual volume, plus X% increase• Annual estimates with some manual adjustments for monthly volume
fluctuations
•Scheduling• Schedule roughly aligned with general volume peaks and valleys• Schedule created on office wall; then added to iCarol• There was also a spreadsheet version
• Full time staff worked mostly M-F between 7a and 7p. • Evenings and weekends handled by part-time and per diem staff (1 to 2 shifts per
week)
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Workforce Management (circa 2012)
•IntraDay/Performance Management• Good real-time “wallboard” which showed who was doing what (on call; on
pause) and how many calls were in queue
• No 24/7 shift supervisor coverage, meant no 24/7 watching of real-time wallboard
• Lack of easily generated and “end-user friendly” reports
• Bad reports and too few supervisors = opportunities for some to take advantage• Had a few employees who were able to “hide” and get away with less than desirable availability
• Variations in services by M-F full time staff and evening/weekend part-time staff
• Quality control and calibration tough to maintain with staff established in their set schedules and no overlap with one another or supervisors
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Technology Management (circa 2012)
•Telephony Systems• Basic ACD system laid on top of free-ware PBX software
• Configured and maintained by IT department
• Set up was IT friendly, but not program friendly
•Reporting & Analytics Software• Excel
• Sequel Databases
Biggest
Challenges
Using Tools
Required to Do
Job (Jan 2012 Counselor Survey)
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Monthly Call Report (Before)Who is DNIS?
Wow. Our new “Untracked” program is really taking off.
LifeNet numbers are really looking good this month—Wait, is LifeNet 6310 or 3218 or both?
At least I can export this information to Excel!
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The Cultural Shift @ Here2Help Connect
•Identify and Implement:• Call Center Operations Best Practices
• Technology to make our jobs easier, not harder
• Better reporting and analytics capacity
•This enables us to:• Ensure we’re putting the resources we have to the best use
• Reduce inefficiencies caused by inadequate and multiple systems so we can focus on our clients
• Improve management and agent reporting so it makes sense and can inform our work
• Demonstrate to funders a coherent business case for exactly what we need in order to successfully meet joint goals
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Continuous Quality Improvement
Measurement
Management
Improvement
Innovation
Data
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Key Performance Indicators
Quality Measures◦ Measures associated with the quality of the services provided by
phone/chat/text, including quality of the contact, resolution of the contact, and actual process of the contact
Service Measures◦ Measures associated with service delivery and overall accessibility of services
provided by contact center
Efficiency Measures◦ Measures associated with how effectively resources are being used to provide
services
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Technology Enhancement Project
•Four Core Components:1. Intelligent Contact Routing (Call, Text, Chat) Phone System
2. Customer Relationship Management (CRM) Solution (Documentation System)
3. Website Enhancement (800lifenet.org)
4. Reporting
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Technology Enhancement Project
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Technology Enhancement Project
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Technology Enhancement Project
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Technology Enhancement Project
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Workforce Management (Now) •Capacity Planning• Regularly project and share # of staff required to meet service levels
• Number shared with agency leadership team and with funder so we’re all on same page with what’s needed for success
• Around 60 agents and 16 MSW student interns
• Mostly MSW social workers; increased number of licensed clinicians
•Forecasting• Forecasting run and reviewed on a weekly basis
• Have established goal of forecasting within 5% of actual
• Forecasting software forecasts volume and Average Handle Time
• Based on actual volume, plus X% increase
• Weekly forecasts with automatic adjustments for variations by day of week, time of day, and AHT
•Scheduling• Schedule aligned with forecasted volume by week
• Schedule created by Optimizer and accounts for volume and AHT by time of day
• Schedule reviewed by Workforce Management Analyst and adjusted as necessary
• Full time, part-time, and per diem staff spread across weekdays, weekends, evenings, etc.
• Required holiday shifts – all counselors required to work 5 holidays per year (receive double-time)
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Schedule Management
This report shows forecasted vs. actual interactions by hour of the day.
The better our forecasting becomes, the more accurate we can be with our scheduling.
This report shows forecasted vs. actual FTE count by hour of the day.
This report shows where our staffing gaps exist and helps inform where to add/adjust scheduled staff.
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Schedule Management
System allows management team to visualize schedule. Workforce Manager can click and drag to adjust scheduled breaks and lunches to ensure coverage.
This view shows forecasted Counselors needed, Counselors scheduled, and variance between the two by 30 min increment.
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Workforce Management (Now) •IntraDay/Performance Management• Good real-time “wallboard” which showed who was doing what (on call; on
pause) and how many calls were in queue• Supervisor and agent views so that different information can be provided based on roles
• 24/7 shift supervisor coverage
• Easily generated and “end-user friendly” reports
• Scheduled automatic reports
• Good reports and great supervisors means everyone is accountable
• Same customer experience around the clock due to more flexible work weeks
• Quality control and calibration monitored and managed by Quality Improvement Manager – Weekly calibration meetings to review scoring
• Group supervision agenda informed by content of calls, as well as performance of center
• It’s proven to be an important venue to introduce/address certain efficiency metrics and explain face-to-face the impact of noncompliance on quality of service.
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Call Reports
I can easily share this report with my team because we all know “LifeNet” means LifeNet.
Better reports = easier to pinpoint successes and opportunities.“Nice work team! We exceeded SLA all but 4 days. What caused the blips on 6/4 and 6/16?”
Glad to see clients starting to use chat. How can we better utilize chat to serve our clients?
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User Availability Report
This report allows us to better understand where Counselors are spending their time.
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User Productivity Summary
This report allows us to better understand where Counselors are spending their time.
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User Call Summary
This report allows us to better see and understand inbound and outbound call basics.
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Schedule Adherence
85% in August66% in June
Implemented Workforce Management Software June 2015 and silent monitored
progress. Within 2 mo., were at 85%. October 2015 is exceeding 90%!
Schedule Adherence = How closely did Counselor work scheduled shift
• Includes sticking to scheduled breaks and lunches.
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Schedule Adherence
•Example of Good Adherence:
97.12% Adherence
Includes:• 2 unscheduled self-
care pauses• late break
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New Website – LifeNet.nyc
Page 31
New web site promotes self-
service option and has dedicated
portal for providers.
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Technology Management (Now) •Telephony Systems• Robust and scalable multi-channel ACD telephony system
• Skills based routing
• Configured by IT department, maintained by Operations Team
• Set up is program and IT friendly—consistent naming conventions
•Reporting & Analytics Software• Robust set of standard call center reports available on demand
• Can run based on any increment to enable management team to dive into the details to find and address areas of opportunity
• New monthly program report template established; coded in “R” software language
•Quality Improvement• Enhanced supervisory quality improvement measures and reports
• Enhanced consumer input capabilities
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Infusing Technology Into QI
Standardization vs. Flexibility/Diversity By:
Line of service
Method of contact
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Working Toward a Solution1. Identify best practice
2. Fold into stages of call
3. Develop customized measure
4. Make it technologically capable and usable
5. Learn to use it
6. Juxtapose with consumer input
7. Package it together
8. Construct air tight policy
9. Evaluate and amend
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Identify Best Practice• Lifeline recommended QI tool: Good Contact, Collaborative Problem-Solving
• Adapt to fit our needs◦ Fold in stages of the call
◦ Explore specific risk assessment questions
◦ Consider depth of questions without redundancy
◦ Consider core needs and needs by line of service
Establish Good Contact
AssessCollaboratively Problem-Solve
Identify Intervention Along Continuum of
Care
Review and Close
Post-Call Wrap-Up
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The Measure
◦ Version 1.0 ◦ Version 12.0
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Measure in the Telephony System
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…What this really means…
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Quantitative/ Qualitative Feedback
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Consumer InputSelf-selected in IVR
1. Did the conversation you just had help you deal more effectively with your problems?[Yes, it helped me a lot; Yes, it helped me a little; It didn’t really help or hurt; No, it made things a little worse; No, it made things a lot worse]
2. Overall, since the call you made to the center, are you:[Better; About the same; Worse]
3. In general how satisfied were you with the crisis line?[Very much satisfied; Somewhat satisfied; Somewhat dissatisfied; Very dissatisfied]
4. If a friend were in need of similar help, would you recommend the crisis line to him or her?[Definitely yes; Probably yes; Probably not; Definitely not]
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Consumer Input Results
•Launched post-call survey on LifeNet program• All callers have option to take automated post call survey (6.5% response rate)
• Real time feedback on how well we’re serving our callers
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Consumer Input Feedback
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Compare Consumer/Supervisor Rating
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360° FeedbackEmpower consumers to have voice
Bring consumer feedback to funders in a manner that makes an impact
Allow counselors to get nuanced, clinical feedback
Recognize and reward good work- boost morale!
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Low-tech alternativesManually scored form (Excel)
Asking consumers for feedback by phone
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Looking Ahead…1. Construct air tight policy
2. Evaluate and amend
3. Establish measure’s empirical soundness
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Here2Help Connect (Now)•Better understand need for full range of supports required for successful contact center operations.
•Continue to hire great clinicians• Expanded MSW graduate student workforce development program
• Interest and support for implementing volunteer program
•Staff here for the right reasons and at the right time and with great ideas for helping clients
•Offered supportive work environment• Expanded group supervision
• Implemented Wellness Committee
• Implemented employee satisfaction survey
•Provided great content & protocol training• Provide regular reports key call center metrics
• Agent performance evaluations are based on agent level efficiency and quality measures
• Management team is versed in call center metrics and understands revelance and importance of each
Most
Satisfying
Things About
Working Here (Jan 2015
Counselor Survey)
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Results: Consumers
•Quicker access to a counselor for help
•Able to reach us by phone, chat, text 24/7
•Receives high quality clinical care and great customer service on every interaction
•Able to provide immediate feedback on every interaction
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Results: Staff•Increased staff productivity• More calls answered per counselor year over year since 2012
•Improved quality of contacts
•Increased staff understanding of call center metrics and need for simultaneous focus on quality, as well as service and efficiency metrics
•Adapted our adherence goals to maintain important and prized unscheduled self-care breaks
•Moved our work environment from average burnout to low burnout • Based on confidential employee survey with 70% response rate
•Implemented career paths to allow top performers with options for career advancement within our call center and our agency• 6 of 10 leadership & program manager positions are internal promotions
• 4 of 5 Shift Supervisors are internal promotions
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Results: Agency Leadership
•Improved understanding of call center operations
•Better able to quantify and convey impact of services
•More support for employee engagement and wellness spending
•Increased understanding of and support for additional support positions, especially around quality improvement, training, and supervision
•Better understanding of true costs of service to effectively price services for success
•Stronger executive level advocacy to engage funders in serious dialogue regarding funding needs
•Improved ability to receive approval to use agency unrestricted funds to supplement call center services
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Results: Funding Partners
• Better able to quantify and convey impact of services
• Received contract expansions to support additional counselors and services in 2013 and 2014
• Secured one-time technology enhancement funding to completely overhaul call center technology infrastructure in 2014-15
• Successfully amended second largest public contract to include incremental funding increases upon reaching certain thresholds in 2015
• Launched NYC and NYS texting programs (2014 and 2015)
• More accurate measure and manage our costs
• Able to successfully compete with
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Thank You!Thank you to the Here2Help Connect team and IT Department for helping to make this all a reality!
Operations Team◦ Jean Sandler, Director of Operations
◦ Dely Santiago, Assistant Director of Operations
◦ Jennifer Bass, Workforce Management Analyst
IT Department◦ Morgan Baker, Director of IT
Standards Training & Practices Team◦ Anitha Iyer, Ph.D., Clinical Director
◦ Gloria Jetter, Clinical Supervisor
◦ Lisa Jones, Quality Improvement Manager
◦ David Truzman, Training Manager
Special shout-out to STP: David Truzman for training to the measure, Gloria Jetter for embracing and supporting it, and Lisa Jones for following through and making the next steps more than a fantasy
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Questions?
Marshall Ellis◦ 212-614-6376
Anitha Iyer◦ 212-614-6396