The Challenge of Outsourcing an Internal Nurse Triage Call Center


Many healthcare groups have closed their internal Nurse Triage call centers in favor of outsourcing call services to AccessNurse. Although there are numerous reasons for making the change, the top reason why healthcare groups are moving to outsourced models is financial…specifically cost containment. These transitions, however, are not made without mixed emotions on the client side and challenges for the medical call center partner. By learning from our clients as we share our experiences, challenges are embraced and learning and understanding occurs on both sides as to how to design the right service for each client. Below we share AccessNurse’s objectives when implementing an internal medical call center.

Understand the Culture

A prestigious teaching medical center was our first large call center client, and our work together taught us how importance it is to understand the culture of the health system and the community it serves. In this case, the health system’s callers were accustomed to a very high level of technical information and often inquired about the causes and physiology of diseases. Our triage nurses were first taken back by these caller expectations that were not yet commonplace in our world. After the feedback on our calls began to arrive, our gracious client worked with our staff by providing some training sessions, and we increased our staff’s availability of implemented additional clinical resource information so we could satisfy callers’ desires for more in-depth knowledge. Our nurses came to love these calls from such an educated caller network, and they discovered that their own knowledge was increasing. We’re still serving that same client after 12 years of service.

Understand the Emotion

In hospital-based call centers, some of the triage nurses may have worked with the hospital’s physicians in clinical settings before moving to work in the call center. This prior relationship gives triage nurses an intimate knowledge of the physician’s personality and standards of practice. When that hospital’s call center’s nurse triage services are outsourced, there may be reassignments or even layoffs that result in anger and resentment. During transition, it is important that both the hospital and outsourcing providers be sensitive to these situations and honor the work and experience of their staff. These same staff members may very likely become patient callers into the new call center. Existing call center managers often become the implementation project managers, and they bring tremendous value to us when we’re working to establish well-functioning services for the client hospital. We make every effort to help them feel comfortable with our service and understand that we value their help. This attitude of appreciation goes far in developing the entire organization’s acceptance of the new services.

Duplicate the Service First

It is essential to learn the service that is delivered in the existing call center and then to work to duplicate it. This requires that the client be involved in a very detailed discovery process with the new call center providers—call flow, reports, and desired patient experience are all important if the new call center is to succeed. AccessNurse’s experience and technology enables us to share best practices along with numerous enhancements that we can offer for improving existing service delivery. We are very proud of our ability to customize and upgrade a client’s service! However, before suggesting any changes, we must invest in detailed discovery to ensure that the existing service or call branding does not fall short. Enhancements are welcomed after the client is reassured that we can create a seamless service.

Provide a Champion

AccessNurse assigns dedicated Strategic Account Managers to each account. These key participants advocate on behalf of the client for the service and ensure that service objectives are met. They are empowered to challenge our own organization in the best interest of the client’s service delivery! Regular conferences and real time availability ensure that we are on top of every issue and are caring for the client’s patients as if they are our own. Account Managers become involved at the start of implementation and posture the service for success.

Over the years AccessNurse has developed many strong partnerships with clients who were in the challenging position of transferring services from an internal call center to an outsourced call center. Our relationships with the staff and leadership of those organizations have grown as we worked together through tough issues and developed mutual trust and respect. Together, we have come to know about family members and events in our lives, and our clients have come to know our nurses by name as we review calls together. They have also heard their patients’ compliments of our call staff.

Today, in the new health care environment, cost containment and technical services provided by outsourced nurse triage services will be even more attractive and, in some cases, a matter of survival. AccessNurse remains committed and challenged by this service line and dedicated to our clients!

Karen Brown

Karen Brown, RN, is the VP of Business Development for AccessNurse.