What is the best way to do On-Call? I’ll share what some of the best do. But first, let me share this. I think no one should be excluded from On-Call duties. If the message “you don’t have to do call” is communicated, it sends a VERY unhealthy signal through the organization. I believe in a mix of dedicated as well as regular staff. I do not believe in several “shifts” of On-Call. Shift mentalities lead to poor customer experiences as the likelihood of screw-ups and information “mis-exchanges” is increased. If several shifts of On-Call staff are needed, I question the quality of the visits. Things are being missed… Below are four points, in the sequence they should be done in my humble experience:
- Change compensation structures so that it is activity-based. If it is primarily a salary-based system, folks will just do less for the same pay when you start to correct the real issues!
- Visit Design: A hospice can reduce 80% of the On-Call activity simply by doing excellent visits – especially addressing anxiety issues via education and expectation management. This is where the mindset shift from “Provider of Care” to “A Teaching Organization” pays gargantuan dividends.
- I would use a mix of dedicated On-Call staff with regular staff. You don’t want regular staff to never have to do call; otherwise, they get sloppy.
- On the more radical side, some hospices do not work 8:00-5:00. They stagger their staffing into the evening and staff weekends as well.
Your visit design is your biggest factor AFTER you make the structural change in how you compensate On-Call. This leads us back to IRMs. All policies and procedures have to be able to be memorized or recalled easily or they cannot be consistently done. We’ve made huge strides in this area. Lookout for Visit Design II!!
– by Andrew Reed