Decreasing Staff Burden by Streamlining the Phone Tree System

In January 2015, the QI team analyzed data from the phone tree system using a Pareto chart (see attached), which showed that 47.5% of callers used the zero-out option instead of using the listed selections to route their calls to the appropriate service area. Selections of those who did use the phone tree confirmed the anecdotal observations from the live operator line to which the zero-out calls are routed. Most callers were calling for STD-related services. A plan was made to implement a rigorous observational data collection phase using a check sheet to log and categorize calls that came to the live operator after selecting the zero-out option. This was coordinated by the Office of Performance Improvement and conducted by the primary staff member responsible for answering the live operator line and the staff members assigned to fill in for her during the selected weeks. The QI team collected and analyzed these data alongside the automated phone tree system metrics. Staff identified a change theory that hypothesized that if the options in the phone tree were changed to list the most sought-after options first in plain language, then more callers would use the automated system to route their calls instead of selecting the zero-out option. Also, it was determined that a "forcing function" should be implemented at the first level of the phone tree wherein callers were required to select one of the presented options to advance. No zero-out option would be available at this level. Sub-menus would include a zero-out option that would transfer callers to an appropriate staff line. For some menus, this would remain the live operator, and for others, the call would transfer directly to an appropriate staff member in a specific area of the department based on the initial menu selection. To prototype a new phone tree that incorporated the group’s change theory, the strategic planning and operations supervisor, who oversees the main phone system, drafted a prototype of a new phone tree, which was then discussed and refined based on additional staff input. The new phone tree was then incorporated into the phone system upgrade for live testing. This system conversion was completed by collaborating with telecom staff over the course of a year and included drafting and approving technical specifications to create additional mailboxes and refining and re-recording English and Spanish versions of the message scripts for each level of the phone tree that was revised. The main audiences affected by this initiative include the public (e.g., current and potential clients seeking information and services) and front-line staff members who answer the phone calls.

Using a pre-/post-intervention approach to evaluation, two types of data were collected before and after the change was implemented. 1. Types of calls coming into the zero-out live operator line (collected using check sheets during a 2-week sampling period) 2. Options selected by callers using the automated phone tree (report generated monthly from the system) Also, a post-survey of staff who receive calls routed through the system was fielded after the change went into effect to determine whether any unintended consequences were observed.