Outpatient service

After learning more than a year ago that patients were having trouble getting doctors’ appointments, members of the Keizer Station Family Medicine team in Oregon began exploring ways to improve service and access. Their solution? Offer more video visits.

“What we didn’t realize at the time is that this work would put us in a unique position to be ready for the pandemic, which wasn’t on anyone’s radar in fall 2019,” says Ruthie Berrell, medical office director and management co-lead for the Family Medicine/Nurse Treatment Center unit-based team. 

Collaboration by the team’s frontline workers, managers and physicians has served as a partnership model for UBTs in the Northwest Region. It’s also earned the department applause for improving service and access at a critical time in health care, as teams across the enterprise adapt to the rise of virtual care. 

“It wasn’t always easy,” says Molly Maddox, RN, the team’s labor co-lead and OFNHP member. “This took a lot of working out the kinks and working together.” 

Overcoming resistance to change 

One of the team’s earliest challenges involved staff resistance to virtual care. Worried that patients would perceive virtual visits as a “takeaway,” some staff members pushed back. 

“The culture of how we delivered care was in the medical office, and people had different levels of acceptance across the spectrum,” says Caroline King-Widdall, MD, team co-lead and physician in charge. 

So, team members educated their peers on the benefits of virtual care and developed scripting to help them feel at ease offering video appointments to patients.

“People are more comfortable now taking the lead and scheduling appointments,” Berrell says. Others feared that older patients were less tech savvy and would have difficulty accessing their virtual visits. In response, team members posted informational fliers in exam rooms and emailed instructions to patients before their appointments. 

Building team engagement

Key to the team’s success was engaging everyone, including physicians. Medical assistants and nurses partnered with providers to review physician schedules and flag appointments they could convert to virtual visits. 

Also, UBT members participated in weekly huddles “where we brainstormed new tests of change and talked about what worked and what didn’t work,” says Maddox. The team’s efforts paid off. 

Patient satisfaction scores for ease of scheduling appointments jumped from 53% to 85% between August 2019 and December 2020. And because members access video visits through kp.org, website registration among the department’s patients increased by nearly 10% during the past year. 

The hard work has not gone unnoticed. This past fall, the team received the region’s UBT Excellence Recognition Award for improving service and access. 

Maddox attributes the team’s success to strong relationships rooted in partnership. “We know that we would not have had this success if our team didn’t work together.” 

How would you want your mother or grandmother to be treated if she came in for an outpatient appointment at Kaiser Permanente? That’s how we want to treat all of KP’s members. Thousands of unit-based teams are working to make sure every KP member receives top-notch service, from the first phone call to the visit with the care provider to the member’s departure from the facility. Providing great service will make our members’ lives better.

1. Review patient/member satisfaction survey responses with the entire team at weekly meetings and huddles.
2. Connect with patients by making eye contact and addressing patients by name.
3. Keep patients informed by explaining everything you’re doing and all of the next steps.
4. Update patients every 10 to 15 minutes on wait times if there’s a delay.
5. Thank patients and members for choosing Kaiser Permanente for their care. Always ask, “Is there anything else I can do for you?”
6. Provide a “wow” experience during a new member’s first visit.
7. Address wait times by trying changes like an “all hands on deck” approach, so when wait times hit a certain threshold, all available staff members drop what they’re doing and help reduce long lines.
8. Make sure phone calls are answered and messages are returned as quickly as possible.
9. Encourage members to sign up for kp.org.
10. If a patient is upset or has had a bad experience, offer a sincere apology and ask, “What can I do to make this better for you?”