Screening, scheduling: engaging client on first call

I called our agency on Monday Feb 4 to set up an appointment, acting as if I were a consumer. I was pleased that a live person* answered the phone; she was very polite and pleasant. However, I discovered that our "screening process" that determines "appropriateness and eligibility" could use some improvement. I found that the person doing the screening asked me questions, such as the name of my employer, that seemed to have nothing to do with why I was calling and that were too personal to be asking on my first call for help.
 
I was told that a clinician would get back to me within 24 hours to schedule an appointment. I wasn't given an appointment time or the name of a counselor who would call me back. As a consumer, I didn't feel very important. When I hung up the phone I thought about calling other places.

I had also presented myself as a self-pay client. I was told what the fee would be, but replied that I couldn't afford that much. She told me that they had a sliding fee scale but that I should discuss that with the clinician who will call me back. As a consumer, I didn't like that; it felt confusing.

Plan

1. Script the screening process for everyone that might answer the phone. Implement NIATx suggestions: congratulate people for taking the first step, ask about needs and time frames, streamline the screening sheet, removing unnecessary questions / information that are not consumer-friendly for the first phone call.
2. Change the scheduling practices. Insure that anyone who answers the phone has the ability to answer questions and schedule intakes. It is preferable to schedule the client within 48 hours.
3. Develop an incentive program for self-pays and keep it standard throughout the agency; make it clear on the first call when the question is asked.

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*It should be noted however, that the person who conducted this screening is new with the Agency. We plan to have all people within the agency go through this process and evaluate the changes.

The Walk-Through

My appointment was set for February 6 at noon. There were some things that I really liked. The clinician gave me directions to the facility and told me which door to arrive in. That was good and as a consumer cut down on wondering where I was going.
 
However, when I arrived, I entered a big waiting room. I looked around a bit, and wondered if I was supposed to "check in" with someone or not. It felt a little awkward. But the surroundings were comfortable.

The clinician greeted me almost immediately, brought me into her office and gave me the agency's welcome letter that outlines rights and responsibilities. She left me alone in her office for a few minutes to read it privately. As a consumer I felt my privacy was being respected, and it felt as though my confidentiality was secure. I wasn't asked any personal questions in the public area.
 
The clinician made me feel very comfortable and didn't jump into the assessment questions right away; she let me talk, which I liked. We were able to transition into talking about rights and responsibilities, fee's, etc., but it didn't seem abrupt or out of place. However, at one point, she did begin to ask a couple of questions from the assessment sheet, such as questions about abuse. This felt very invasive for my first session. At the end of the session she asked me if I thought it would work out and if I wanted to come back; I felt comfortable enough to say yes. All in all this was a fairly pleasant process. But there were a few areas to be improved.

Plan

1. Make it standard for all clinicians to have the consumer in their office and review the rights and responsibilities, giving the consumer a few minutes of privacy.
2. Change the placement of the abuse assessment questions.
3. Hang up a sign in the waiting room large enough that lets the consumer know their counselor will be right with them and to please make themselves comfortable, taking the mystery out of "if" or "where" to check in.

Summary

For us, these two change projects go hand in hand. We will implement these changes immediately and study them over the course of the next couple of months. We will have another clinician do a walk through with the changes implemented and review the results, continuing with the change process as necessary.
 
All in all this process was very eye-opening. This is information that we would likely not have known without doing this study, and we would have continued to wonder why people don't come in for their first appointment, or don't come back. This has provided us with incredibly valuable information on how to better serve our consumers and make the process much more user friendly for a person seeking treatment. I am looking forward to having the other clinicians experience what the consumer experiences and hearing their feedback. 
 
Catherine Bell, LADC, CCS
Crooked River Counseling, PA
Norway, ME