Denver Health Patients Front and Center

The Appointment Center ensures patients find the right service at the right time, from a routine physical exam to emergency care.

For Michael Keelan, Denver Health Director of the Appointment Center and Medical Interpretation, transforming the center using the Lean Academy Principles was second nature.

Keelan not only wanted the center to avoid making so many mistakes in appointments and losing callers to abandonment rates, he also wanted systems in place to ensure the process would continue to become more convenient and beneficial for patient and providers.

Steeped in the principles of Denver Health Lean Academy, he set about to improve everything from average speed to answer at the call center to staff morale and career paths. He hired Kristine Gaw, Operations Manager, a Lean coach, to help ensure the center would become proactive rather than reactive in meeting the burgeoning challenges of evolving health care.

Keelan started by changing the work environment into one where employees and supervisors felt more “open, collaborative and trusting” he said. “I think what’s most important to me is the departmental vision. ‘Are we aligned with the organization’s vision?’ Does the whole team know what it is that we are trying to achieve?” Keelan asked. “What we’re trying to do is put the patient at the forefront.”

He also needed to understand staff concerns. After a lengthy session hearing them out, he said, “there were many ‘aha’ moments for everyone.” Supervisors had been convinced they needed more people, as many as 13 more full-time-equivalent positions. A year before the center had added 15 FTEs. It was a big red flag for Keelan. In probing deeper, they discovered that trying hard to maximize productivity and eliminate any downtime had unintended consequences.

“Everyone was doing everything,” Keelan said. “Everybody was trying to be busy and productive. But nobody had visibility as to what others were doing. We might have 20 people trying to make follow-up outbound calls in the same five minutes, while few were taking inbound calls. This created bottlenecks.” Frustrated employees were afraid to speak out about their problems.

One answer was to switch to single-tasking, with teams dedicated to being expert in either in-bound calls or outbound calls. Quality of service rather than quantity of calls became the focus. But both improved. “We made true experts in specific areas and created a more defined career path for people.” Keelan said. “It’s not as stressful for them.”

The center began taking 10,000 more calls a month, while staff turnover decreased dramatically.

“Now everybody knows what we’ve been doing that works. Next, we look at how to improve more,” Gaw said. “What gets measured, gets done.” This principle is applied to every task and phase of work. And employees who were once afraid to weigh in on issues are now open collaborators.

“Lean is all about engaging the employees,” Keelan said. “They do this job every day. They’re the experts. We’re all leaders. That’s Lean’s guiding philosophy.”