No hang-ups: UCHealth builds single referral phone system

Northern Colorado hospitals to join DocLine starting Feb. 1
January 23rd, 2017

DocLine will be getting a major upgrade before its second birthday.

DocLine, originally launched at UCHealth Memorial Hospital and University of Colorado Hospital in March 2015, is a direct line for referring providers who want to transfer patients to a UCHealth facility or consult with one of its providers. The line is staffed by a team of specialists and critical-care nurses, now numbering more than two dozen, who expedite physician-to-physician contact, transportation details, bed assignments, nurse reports, and other details.

The expansive new transfer center on the fifth floor of AIP 2, two days before opening.
The expansive new transfer center on the fifth floor of AIP 2, two days before opening.

UCHealth upgraded the DocLine phone system in the fall of 2015, significantly improving the intrastructure, backup systems and access to “life-critical services,” said Rob Leeret, senior director for DocLine. Now more changes are in the works, including extending DocLine’s reach.

True north

Beginning Feb. 1, DocLine will also handle transfer and consultation requests from referring providers for UCHealth Poudre Valley Hospital and Medical Center of the Rockies. For more than a decade, such calls have been routed through the PATH, a service similar to DocLine.

A monitor in the transfer center displays a weather map, live views of ambulance bays at UCHealth hospitals, and the ED status of hospitals in the Denver metro area and other regions.
A monitor in the transfer center displays a weather map, live views of ambulance bays at UCHealth hospitals, and the ED status of hospitals in the Denver metro area and other regions.

The ultimate aim: continue to build UCHealth’s reputation as the premier tertiary and quaternary referral center in the state and region – and one that is easy to access.

“We want to leverage the impact and size of the system to ensure that UCHealth can help all hospitals with their patient transfers,” Leeret said. “We are working with our staff and physician groups to knock down the barriers to those transfers.”

Leeret noted that an executive DocLine Steering Group, which included all UCHealth chief medical officers, DocLine Executive Director Richard Zane, MD, and other physician leaders from across the system, agreed that bringing all hospitals into the DocLine fold was “the most efficient, reliable and easiest way” for referring physicians to contact UCHealth physicians.

“We will now have one comprehensive transfer line that can serve all needs of referring physicians” Leeret said.

Thomas Downes, MD, chief medical officer for UCHealth PVH and MCR, added that the expanded DocLine gives a referring provider a simple, user-friendly way to send their patients to any UCHealth campus for any kind of care.

“What we want as a system is to create a service that offers the best possible experience for referring providers,” Downes said. That means a system with a single number, backed by service that encourages them to use the line repeatedly, he added.

Bigger brain center

Another overhead monitor shows the overall and individual unit capacity at UCHealth hospitals.
Another overhead monitor shows the overall and individual unit capacity at UCHealth hospitals.

The calls will be routed through a new and much larger transfer center, modeled on industry leaders, such as Erlanger Health System in Chattanooga, Tenn., Leeret said. The center opened on the fifth floor of UCH’s Anschutz Inpatient Pavilion 2 on Jan. 19. The roughly 2,000-square-foot space is more than triple the size of the crowded center on the first floor of AIP 1 that housed critical-care nurses answering calls, said Larissa Thorniley, RN, nurse manager for DocLine. That space has been their home since it was known as the Access Center.

The new center features ergonomically designed work spaces and sound-baffling tiles, important improvements for staff, Thorniley said. For example, the old center was separated from the Financial Counseling office only by a thin wall, and staff had little opportunity to move about other than during assigned break times – especially difficult for nurses who built their skills working physically active 12-hour shifts on hospital units, she noted.

Indeed, the new space includes a workstation with a treadmill and all work spaces will allow staff to stand during their long shifts. The center, which can accommodate 21 people, holds banks of overhead monitors that display real-time capacity metrics at each hospital; bed status and admissions; live views of ambulance bays; and the status of emergency departments around the metro areas that UCHealth serves.

“This service and this center is another important step on the evolution to becoming a world-class system,” Zane said.

Busy lines

The physical expansion is in line with growth in the number of calls handled by DocLine. For the first five months of fiscal year 2017 – July 1 to Nov. 30, 2016 – the number of inpatient and outpatient transfers from non-UCHealth facilities to UCHealth Memorial Hospital (Central and North) increased 16 percent, Thorniley said. The number of “bedded” patients – those admitted to inpatient or observational units – grew 21 percent.

TeleTracking board shows in real time admissions to each hospital and bed status.
TeleTracking board shows in real time admissions to each hospital and bed status.

At UCHealth University of Colorado Hospital, the increases for the same period were 14 percent and 18 percent, respectively. With the PATH coming into the fold, the numbers should increase substantially, Thorniley added. During the same five-month period, The PATH handled about 900 calls a week.

These transfer numbers represent only a fraction of the total number of calls DocLine staff handle, Leeret added. The total includes consults as well as transfers to UCHealth’s emergency departments from referring providers. The combined number of all cases from Dec. 1, 2015 to Nov. 30, 2016 for all UCHealth hospitals was close to 32,000, Leeret said.

Downes conceded that UCHealth providers in northern Colorado didn’t instantly accept the idea of retiring the PATH. “Some of them felt that we had spent years honing it, so why disrupt it now?” he said. Some also worried that DocLine staff might route patients in the region to other UCHealth hospitals, he said.

Out of many, one

But a single line presents many advantages, Downes added, including ensured round-the-clock coverage and a beefed-up phone system to

A treadmill at one of the workstations in the transfer center will allow staff to stay active during long hours. All workstations are built for standing while working.
A treadmill at one of the workstations in the transfer center will allow staff to stay active during long hours. All workstations are built for standing while working.

minimize downtime. He noted that from its inception DocLine has recorded all calls. In addition, Leeret and Thorniley routinely provide detailed analysis of the data collected, including the reasons for the small number of declined transfers – just five in November 2016 compared to 502 accepted requests at UCH – the accepting service lines, top referral sources, payer sources, and more.

Leeret emphasized that DocLine has always met the wishes of referring providers who ask that their patients be transferred to a specific UCHealth hospital and will continue to do so.

“Rob has been diligent in making certain there are no violations of that,” Downes said. “With all calls recorded, we can totally track what our referring providers want and where the patients show up.” A single, well-staffed, reliable line promises to protect the well-established patient bases in each region while “ensuring that all boats rise with good system service,” Downes said.

Ultimately, Downes concluded, DocLine’s service should compare favorably with that of one of the world’s best-known brands.

“We want to make it sort of like a Disneyland experience for referring docs,” Downes said. “All of their needs are met very quickly and easily and they can get off the phone and go about their day.”

“As the only integrated academic system delivering tertiary and quaternary services for not only Colorado but also this region of the country, we need to be a resource for the community and the path of least resistance for referring physicians and their patients,” Zane added. “After all, we are who they turn to when they need help, whether it’s arranging the transfer of a patient who needs more advanced medical care or connecting them with a specialist who can help them care for their patients where they are.  If we can’t help, nobody can.”

About the author

Tyler Smith is a freelance writer based in metro Denver.