ahrq-gov/archive.ahrq.gov/prep/callcenters/callapp3.htm
2025-02-28 14:14:25 -05:00

341 lines
22 KiB
HTML

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Adapting Community Call Centers for Crisis Support: A Model for Home-Based Care and Monitoring. Appendix 3</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<!-- "metadata" -->
<meta name="Title" content="Adapting Community Call Centers for Crisis Support: Model for Home-Based Care and Monitoring" />
<meta name="description" content="Model for community health call centers to support home-management and shelter-in-place approaches in mass casualty or pubic health emergency events." />
<meta name="keywords" content="Agency for Health Care Policy and Research, Agency for Healthcare Research and Quality, AHRQ, AHCPR, bioterrorism, community resources, disaster preparedness, emergency, hospital, mass casualty event, public health, surge capacity, urgent care" />
<meta name="creator" content="Agency for Healthcare Research and Quality (AHRQ)" />
<meta name="datecreated" content="October 2007" />
<meta name="datereviewed" content="October 2007" />
<meta name="language" content="English" />
<!-- "end metadata" -->
<link href="/includes/archive.css" rel="stylesheet" type="text/css" />
<link href="/includes/ahrqstyleprint_arch.css" rel="stylesheet" type="text/css" media="print" />
<script>
(function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
})(window,document,'script','//www.google-analytics.com/analytics.js','ga');
ga('create', 'UA-75759936-1', 'auto');
ga(' set', 'anonymizeIp', true);
ga('send', 'pageview');
</script></head><body><!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-W4DST4"
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
'//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
})(window,document,'script','dataLayer','GTM-W4DST4');</script>
<!-- End Google Tag Manager -->
<noscript>
Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser.
</noscript>
<!-- Page Header v2.0 -->
<a name="top" id="top"></a>
<!--Begin Banner CodeS-->
<div id="ahrqbanner">
<div class="hhsportion">
<a href="#h1" class="skipnav">Skip Navigation</a>
<a href="http://www.hhs.gov" title="U.S. Department of Health and Human Services">
<img src="/images/hhs_banner.gif" alt="U.S. Department of Health and Human Services" />
</a>
<a href="http://www.hhs.gov" title="www.hhs.gov" class="hhsright">
<img src="/images/hhs_link.gif" alt="www.hhs.gov" />
</a>
</div>
<div class="ahrqportion">
<a href="/" title="Archive: Agency for Healthcare Research Quality">
<img src="/images/ahrq_banner.gif" alt="Agency for Healthcare Research Quality" />
</a><form name="searchForm" method="get" action="https://search.ahrq.gov/search" id="banner_searchform">
<label for="search" style="z-index:-1;position:relative;margin-right:-65px; font-size:0px;">Search</label>
<input name="q" type="text" value=" Search Archive" size="11" onfocus="this.value='';" class="gotext" label="Search archive" id="search" />
<input type="hidden" name="entqr" value="0" />
<input type="hidden" name="output" value="xml_no_dtd" />
<input type="hidden" name="proxystylesheet" value="ARCHIVE_Front_End" />
<input type="hidden" name="client" value="ARCHIVE_Front_End" />
<input type="hidden" name="site" value="ARCHIVE_AHRQ_GOV" />
<input src="/images/topbn_GoButton.gif" class="gobtn" name="Submit" onclick="javascript:document.searchForm.submit();" type="image" alt="Search" />
</form>
<a href="https://www.ahrq.gov/" class="ahrqright">www.ahrq.gov</a>
</div><div class="ahrqlinks"><a href="https://www.ahrq.gov/">AHRQ Home&#8212;Live Site</a> | <a href="/">Archive Home</a> | <a href="/sitemap.htm">Site Map</a> <!-- | &nbsp;<img src="/images/envelope1.jpg" alt="" width="21" height="14" /><a href="https://subscriptions.ahrq.gov/service/multi_subscribe.html?code=USAHRQ">E-mail Updates</a> --></div>
</div>
<div id="PrintBanner">
<img src="/images/printbanner_arch.jpg" alt="Archive print banner" />
</div>
<a name="h1"></a>
<!-- End banner code -->
<!-- End of Page header -->
<!-- Content Body -->
<div id="mainContent">
<table width="100%" border="0" cellspacing="0" cellpadding="0" >
<tr valign="top">
<td width="70%">
<!-- Center Content section -->
<table width="100%" border="0" cellpadding="0" cellspacing="0" style="margin-left:10px; margin-right:10px;margin-top:5px" summary="This table gives the layout format of the bread crumb area and the center content area.">
<!--DWLayoutTable-->
<tr>
<td class="crumb_link"><div id="crumbContent">
<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> &gt; <a href="." class="crumb_link">Adapting Community Call Centers for Crisis Support</a> &gt; Appendix 3</span></p>
</div>
</td>
</tr>
<tr valign="top">
<td height="30px"><h2><span class="title">Adapting Community Call Centers for Crisis Support</span></h2></td>
</tr>
<tr valign="top">
<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
<!-- <p>Now this resource is supported by the <a href="http://emergency.cdc.gov/">Centers for Disease Control and Prevention</a> (CDC).</p> -->
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<h2>Appendix 3. Suggested Elements for Public Health Information and Decision Support Hotlines: The Health Emergency Line for the Public (HELP) Model</h2>
<a name="top" id="top"></a>
<h3>Contents</h3>
<p><a href="#Introduction">Introduction</a><br />
<a href="#Goals">Goals and Lessons Learned</a><br />
<a href="#Elements">Elements of a Telephone Information and Decision Support System</a><br />
&nbsp;&nbsp;&nbsp;<a href="#Call">Call Handling Requirements and Support Services</a><br />
&nbsp;&nbsp;&nbsp;<a href="#Levels">Service Levels</a><br />
&nbsp;&nbsp;&nbsp;<a href="#Users">Service Users</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Multipurpose">Multipurpose/Multifunction Support Services</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Recordings">Use of Recordings and Other Information Resources</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Technology">Use of Call Center Technology</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Topics">Information Topics and Content</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Training">Staff Training and Quality Control</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Data">Data Collection and Reporting</a><br />
&nbsp;&nbsp;&nbsp;<a href="callapp3-2.htm#Adaptability">Adaptability and Utility</a><br /><br /> <strong>Appendixes</strong><br />
<a href="callapp3a.htm">Appendix 3-A. Sample FAQ from West Nile Virus Library</a><br />
<a href="callapp3b.htm">Appendix 3-B. Sample Report Items and Data Graphs</a> </p>
<h3><a name="Introduction" id="Introduction"></a>Introduction </h3>
<p>The Rocky Mountain Regional Health Emergency Line for the Public (HELP) program provides a model for disseminating and collecting information in health emergencies. In our experience, the basic call center infrastructure and elements of HELP are needed to support the tools described in this report. This appendix describes those HELP elements so that similar capabilities can be developed within existing community health call centers to support outpatient health care and monitoring during public health emergencies. A more complete discussion of the
requirements for call center infrastructure (people, processes, and technology) can be found in the Health Emergency Assistance Line and Triage Hub (HEALTH) model report on the Agency for Healthcare Research and Quality Web site (<a href="/research/health/">https://www.ahrq.gov/research/health/</a>).</p>
<p class="size2"><a href="#top">Return to Appendix 3 Contents</a> </p>
<a id="Goals" name="Goals"></a>
<h3>Goals and Lessons Learned</h3>
<p>The HELP program objectives, which we developed with our public health partners include:</p>
<ul>
<li>Developing a standardized and prepared response to public health events.</li>
<li>Providing consistent, accurate information.</li>
<li>Collecting and maintaining structured data to better characterize events and responses.</li>
<li>Developing capability and capacity to adapt to other public health emergencies.</li>
</ul>
<p>Essential components for a standardized and prepared response include:</p>
<ul>
<li>Call handling procedures.</li>
<li>Call center infrastructure/technology.</li>
<li>Toll-free lines with up-to-date recordings.</li>
<li>Integrated Web site.</li>
<li>Trained information providers.</li>
<li>Defined referral procedures.</li>
<li>Consistent, accurate information delivery.</li>
<li>Structured data collection and reporting.</li>
</ul>
<p>In our experience with operating health/medical call centers and responding to health
emergency events, we learned a number of valuable lessons:</p>
<ul>
<li>Structured upfront planning is essential.</li>
<li>All call center staff should have a basic understanding of the flow of information.</li>
<li>Systems need to be flexible to:
<ul>
<li>Meet any challenges or unexpected questions and requests for information.</li>
<li>Update/change the information provided as new data becomes available.</li>
<li>Adapt to unpredictable and changing call volumes.</li>
<li>Provide additional trained staff when call volumes increase.</li>
</ul></li>
<li>A formal and timely communications process must be in place that includes constant
reviews and revisions of the information so that only the most current and correct
information is provided to callers.</li>
</ul>
<p>The last lesson relates to quality control mechanisms that will ensure the success and
continual improvement of hotline services, as well as provide the call center with the capability
to provide specialized information customized to the health event.</p>
<p>In planning for future events, it is clear that data collection must be sensitive so that it can:</p>
<ul>
<li>Identify special populations and capture the needs of those populations.</li>
<li>Be flexible enough to address those needs.</li>
</ul>
<p><strong>Summary:</strong> Call centers are a valuable resource in providing consistent and accurate
information not only to the general public but also to health care providers, as well as between
health care providers and health departments. The goal is to develop a program that can provide
much-needed support for those affected, those with concerns (worried well), and those
professionals managing the incident.</p>
<p class="size2"><a href="#top">Return to Appendix 3 Contents</a> </p>
<a id="Elements" name="Elements"></a>
<h3>Elements of a Telephone Information and Decision
Support System</h3><a id="Call" name="Call"></a>
<h4>Call Handling Requirements and Support Services</h4>
<h5>Authorization and Liability</h5>
<p>Call flow processes, scripting, and the prepared responses to frequently asked questions
(FAQs) should be approved by the appropriate agency (i.e. public health department) or other
client. These must be carefully followed during call delivery. Adding unapproved information or
personal opinions creates liability for the persons delivering the service, for the contact center
itself, and for the client agency.</p>
<p>If call center personnel (licensed professionals or information providers) have a process-related
concern arising from the scripts or decision trees when speaking to a caller, they are to
contact supervisors immediately. If the information specialist or clinician handling a call has any
concern or is uncomfortable with how the call resolved, they should report the call identification
number, date and time of the call, person handling call, and situation/concerns to a supervisor or
to quality assurance personnel.</p>
<h5>Security, Confidentiality, and Compliance</h5>
<p>All caller information should be treated as confidential and shared only with call center and
client agency employees for whom it is appropriate. It should be determined whether it is
necessary to comply with any provisions of the Health Insurance Portability and Accountability
Act (HIPPA). If the client agency is a public health entity, or if the call center is involved in
responding to a community emergency, there may be exemptions from HIPPA
(<a href="http://www.cdc.gov/od/science/regs/privacy/index.htm">http://www.cdc.gov/od/science/regs/privacy/index.htm</a>).</p>
<p>To safeguard patient health information and confidentiality, do not send E-mails or online
reports that contain caller identification information unless the content is encrypted. Also
consider collecting non-sensitive information. For example, collecting only a caller's zip code
and county reduces the amount of information to collect and thereby shortens call times, while
still allowing staff to answer questions, supply information, and report situational awareness
information to the state health department (i.e. the top information requests by county). This
minimal information approach also reduces any potential barriers for callers who may not feel
comfortable providing names, addresses, phone numbers, and other identifying information.
However, callers may be comfortable supplying additional identifying information,
depending on the situation. If a caller's questions cannot be addressed immediately (for example,
the information is not available and a response request must be E-mailed to a State
epidemiologist) callers can be given the option to supply contact information so they could be
called back with a response. Also, if they were reporting an incident, such as a dead bird during a
West Nile Virus outbreak, they might supply location information (at least cross streets) to allow
for geo-coding of data.</p>
<p><strong>Summary:</strong> It is important to determine what the data needs are for either providing information to or
collecting information from the public to allow for adequate disease outbreak management and
situational awareness for the specific incident being addressed.</p>
<p class="size2"><a href="#top">Return to Appendix 3 Contents</a> </p>
<a id="Levels" name="Levels"></a>
<h4>Service Levels</h4>
<p>A two-level service system was developed to respond to the needs of different clients and
incidents. Level 1 involves only basic information collection and dissemination, while Level 2
involves more advanced clinical triage or decision support. We have developed our platform to
provide Level 1 service and use information providers only (unlicensed staff). We have the
capability to expand to Level 2 service if the client or incident requires by bringing in clinical
staff. However, in many incidents there may be a lack of clinical professionals available to
handle calls; therefore, we chose to concentrate on Level 1 service that information providers can
deliver.</p>
<table border="0" cellspacing="0" cellpadding="3" width="90%">
<thead>
<tr valign="top" align="left">
<th scope="col" width="50%">1. Level 1 Service</th>
<th scope="col" width="50%">2. Level 2 Service</th>
</tr>
</thead>
<tr valign="top">
<td scope="row">
<ul>
<li>Recorded information on current event status</li>
<li>Information Providers give approved content through FAQ's</li>
<li>Data collection as required by client</li>
<li>Reporting and data analysis as required by client</li>
</ul>
</td>
<td>
<ul>
<li>Recorded information on current event status</li>
<li>Information Providers give approved content through FAQ's</li>
<li>Decision support for public with suspected related symptoms<a href="#ast">*</a></li>
<li>Decision support for providers treating public<a href="#ast">*</a></li>
</ul>
</td>
</tr>
<tr valign="top">
<td scope="row">
<p><strong>Delivery Method</strong></p>
<ul>
<li>Telephone</li>
<li>Web site</li>
<li>Information Providers</li>
</ul>
</td>
<td>
<p><strong>Delivery Method</strong></p>
<ul>
<li>Telephone</li>
<li>Web site</li>
<li>Information Providers</li>
<li>Registered Nurses<a href="#ast">*</a></li>
</ul>
</td>
</tr></table>
<p class="size2"><a id="ast" name="ast"></a>* Level 2 that includes clinicians such as nurses providing decision support for the public and providers will require pre-designed protocols/clinical decision trees specific to the event.</p>
<p><strong>Summary:</strong> Planners should first determine the type of service level that they intend to provide and then staff appropriately. It is then important to establish the precise services that are needed before
developing the support systems and procedures for them to properly function.</p>
<p class="size2"><a href="#top">Return to Appendix 3 Contents</a> </p>
<a id="Users" name="Users"></a>
<h4>Service Users</h4>
<p>It is helpful to determine the expected potential service users and to begin to forecast what their needs may be. Though we intended to provide services to primarily the general public, we found there were many other service users that we had not anticipated, and we had to develop resources in order to meet their needs. The following figure demonstrates the different user groups we have identified from operating the HELP program.</p>
<a name="Fig1" id="Fig1"></a>
<img src="app3fig1.gif" alt="Figure shows potential users of the HELP program. For details, go to [D] Text Description." longdesc="https://www.ahrq.gov/prep/callcenters/app3fig1text.htm" />
<p class="size2">[<a href="app3fig1text.htm">D</a>] Select for <a href="app3fig1text.htm">Text Description</a></p>
<p><strong>Summary:</strong> Planning for specific user groups will help in the development of appropriate resources and information; however, planners should be prepared to adapt services to new user groups as situations require.</p>
<p class="size2"><a href="#top">Return to Appendix 3 Contents</a><br />
<a href="index.html#contents">Return to Contents</a><br />
<a href="callapp3-2.htm">Proceed to Next Section</a></p>
<p>&nbsp;</p>
<div class="footnote">
<p> The information on this page is archived and provided for reference purposes only.</p></div>
<p>&nbsp;</p>
</div>
</td>
</tr>
</table>
<!-- End of Center Content section -->
</td>
</tr>
</table>
</div>
<!-- End of Content Body -->
<!-- Footer graphic 1.2-->
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tr>
<td width="125" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_1.jpg" width="125" alt="AHRQ" /></td>
<td width="100%" background="/images/bottom_ahrq_bkg.jpg" ><img src="/images/bottom_ahrq_bkg.jpg" width="10" height="34" alt="" /></td>
<td width="310" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_2.gif" alt="Advancing Excellence in Health Care" width="310" height="34" /></td>
</tr>
</table>
<!-- Footer links section -->
<div id="banner_Footer2"><p> <a href="https://www.ahrq.gov/">AHRQ Home</a> | <a href="https://info.ahrq.gov" class="footer_navlink">Questions?</a> | <a href="https://www.ahrq.gov/contact/index.html" class="footer_navlink">Contact AHRQ</a> | <a href="https://www.ahrq.gov/sitemap.html" class="footer_navlink">Site Map</a> | <a href="https://www.ahrq.gov/policy/electronic/accessibility/index.html" class="footer_navlink">Accessibility</a> | <a href="https://www.ahrq.gov/policy/electronic/privacy/index.html" class="footer_navlink">Privacy
Policy</a> | <a href="https://www.ahrq.gov/policy/foia/index.html" class="footer_navlink">Freedom of Information Act</a> | <a href="https://www.ahrq.gov/policy/electronic/disclaimers/index.html" class="footer_navlink">Disclaimers</a> | <a href="http://www.hhs.gov/open/recordsandreports/plainwritingact/index.html" class="footer_navlink">Plain Writing Act</a> <br />
<a href="http://www.hhs.gov" class="footer_navlink">U.S. Department of Health &amp; Human Services</a> | <a href="http://www.whitehouse.gov" class="footer_navlink">The White House</a> | <a href="http://www.usa.gov" class="footer_navlink">USA.gov: The U.S. Government's Official Web Portal</a></p>
</div>
<div id="banner_Footeraddress"><p>Agency for Healthcare Research and Quality <img src="/images/bottom_dot.gif" alt="" /> 5600 Fishers Lane Rockville, MD 20857 <img src="/images/bottom_dot.gif" alt="" /> Telephone: (301) 427-1364</p></div>
<!-- End of Footer links section -->
</body>
</html>