Case Management Software Workflow Automation Improves Quality of Care
by Greg Stanley-Horn
One of the key factors that contribute to maximizing client outcomes of service is adherence to best practices in clinical treatment.
These best practices typically involve a ‘what’ – the course of action most suited to the situation at hand – a ‘how’ that also factors in client values and preferences, and a ‘when’ – the timing and frequency of the actions.
We will assume here that the ‘why,’ ‘where,’ and the ‘who’ are already identified, but these too could be clarified and integrated into a more robust workflow automation context.
Using technology to serve as a background driver of routine processes allows clinical staff to use their skills, training and experience to best effect among the myriad tasks, crises and responsibilities that demand their attention across their case load and work days.
In this light, the technology they use is valuable in surfacing the key information elements that need attention and ensuring that (agency-approved, prior-) appropriate actions are performed in the timeframes appropriate to the client service delivery context.
The combination of the right action at the right time with the right people involved is a core driver for optimum client outcomes while also serving to reduce the overall cost of service for the agency (through the rational, informed allocation of scarce resources).
This evidence-based model assumes that the agency is in a position to pre-determine in some sense what “right” answers are to be applied to which conditions.
On a very basic level, this means – when faced with a given set of conditions or circumstances – simply doing what the best available evidence says should be done in the time frame specified.
A silly scenario can help illustrate this – when my eight-year-old son scrapes his knee after a fall on his bike, the application of a hug, iodine and a Band Aid (the ‘what’) are to be applied immediately, without delay (the ‘when’) by someone appropriate (the ‘who’ – me!).
How Automated Workflows Can Help Drive Client Engagement
Now let’s look at an example illustrating how Penelope Case Management Software’s innovative and unique workflow automation and collaboration tools can drive better outcomes in a value-based family service care setting.
Inbound referrals are often mandated (and these mandates serve as their own incentive), but it is also common for agencies to receive voluntary requests for service from clients.
From the client’s perspective, this often is the result of a very long decision process that is fraught with stress, doubt and great personal risk.
Reaching out for help / assistance is a deeply courageous act that should be answered (or rewarded) with a clear set of next steps.
Using Penelope’s Intake Wizard to quickly and easily record the details of the call and the client’s basic demographic information provides for standardized data collection while supporting a natural conversation-like flow with the caller (which also serves to reduce downstream administrative data entry and redundant client time-wasting form-filling).
Some agencies may insert a quick screen of some kind into this process to quickly assess for some risk or other issue, and this can be built into the process with staff prompted to complete this information based on answers provided by the caller.
Normally, however, the next most efficient step is to try to leave them with the tangible next step of an actual appointment time with their initial service provider / clinician.
By using Penelope’s Service Wizard, the staff taking the call can rapidly view the availability of appropriate staff members in real time and, using some matching / preference characteristics, use a couple of clicks to enrol the client(s) into service, assign their initial service provider and schedule the first (or many recurring) appointments.
While other aspects of the service registration process can be done seamlessly as part of this process (such as setting fee for service / sliding scale rates, assigning third party funding, recording presenting issues and other considerations such as interpreters required, etc.), these two simple ‘wizards’ help to take a client from initially reaching out to a tangible next step quickly and efficiently.
Behind the scenes, other processes can be set in motion – such as an automated email sent to the client reminding them of their initial appointment, an automatic pre-service form or assessment that’s automatically emailed to them to complete online, etc.
This kind of instant confirmation and feedback helps to validate the client’s decision to reach out and also serves to increase the likelihood that they will “show” for their first appointment.
Collaboration Tools Keep Staff Engaged
On the staff side, they are also instantly notified via Penelope’s Collaboration Suite (or by email / SMS text message if they’re not currently logged in) that they have a new case assigned to them, that their calendar has a new appointment and possibly of other workflow tasks that are part of this new client enrollment.
In summary, rather than taking the caller’s information and passing it on to a staff person to try reaching them via call-backs, we have seized the opportunity of a client reaching out – reducing barriers to service, improving client throughput, reduced wait times / decreased time between initial call and initial appointment, and improved service responsiveness by using tools like Penelope to match the most appropriate service provider to the values, needs and preferences of the client.
These are all essential elements of good service that apply to any organization.
How Penelope Can Help with Service Plan Best Practices
Best practice typically dictates that overall services to be provided by the agency to the client are directed by some form of service plan that engages with the client(s) and possibly third parties to identify their strengths, values, issues, goals and objectives of service, and that this service plan development process should commence after an initial assessment and discovery phase.
Agencies can help structure this and help guide their service providers by providing automated workflows, reminders, prompts and context-based tools (e.g. smart forms, assessments, service planning templates, letters, etc.) with associated timescales.
An action may be for example in this case that within 14 days of the first appointment, a service plan must be completed. Once the service plan is complete, the smart form can automatically be sent to the supervisor for approval if needed (again for best practices, this is common as supervisory oversight contributes to better quality care — e.g. more clearly expressed clinical formulations and goal statements).
The supervisor and the service provider (and their colleagues) can use the Collaboration Suite in Penelope to communicate and collaborate on the service plan.
Once signed off by the supervisor, the client can digitally sign-off on it (on screen) the next time they are in the office — this reduces administrative effort, ensures regulatory compliance (also – if the signatures are not in place, then this can raise an alert and trigger a workflow), and provides good audit trail visibility.
As the service plan’s formulation may take weeks to pull together and can require input from multiple stakeholders (inside and outside the agency) – Penelope’s Collaboration Suite / Discussions are an ideal workspace for coordinating this effort – again, assisting in providing the best, most timely and responsive service to the client while also providing detailed logs of all steps (and care and consideration) taken to arrive at the service plan’s content – great for auditing, accreditation and staff clinical review.
Perhaps another mandatory step might require clients to review and sign off on consent to service information forms and this too can automatically be sent from Penelope to the client to complete on their smart form 24 hours prior to their initial appointment.
They can also “confirm” their attendance to appointments from their smartphone in advance (this has been shown by research to improve show rates and reduce unbilled direct practitioner time and as a result reduce wait times).
If this consent is not completed within the specified time frame, Penelope will trigger an alert to reception to get it from the client at their arrival (ensuring compliance to regulatory protocols).
When the client shows at the agency, reception staff can check the client in and notify their practitioner of their arrival in real time – directly within Penelope (saving client and staff time).
You can embed any number of additional automated workflows as appropriate (to automatically send clients “general level of functioning” self-assessments prior to each session and satisfaction surveys after every appointment, etc.).
The service plan might recommend that the client receive X, Y Z and services at the agency and an outbound referral to agency B.
Penelope provides tools to track and record this activity in a coordinated and unified case file, record follow-ups and external communications and reporting.
Best practice dictates that session notes need to address the specific goals and objectives identified in the service plan and Penelope can assist in this by “pushing” those goals and objectives to the staff person’s attention in the session note template itself!
Further, best practice dictates that these service plans need to be reviewed periodically which Penelope can drive via time-based alert as well as client feedback gathered at various stages which Penelope can also automate via our Engage client platform tools.
Penelope streamlines even the process of updating service plan reviews as the smart forms can help populate the review documents with previously completed information – saving time and improving accuracy.
Workflow Tools can Help Monitor Data and Client Wellbeing
There are many, many other examples that could be described to demonstrate the manifold ways that Penelope can drive better clinical practice at lower administrative cost.
The last one I will touch on for now is one that is under-utilized but has the potential to profoundly impact on how services are delivered around the world: Penelope’s workflow automation tools can not only push out smart forms, assessments and actions to clients and staff to complete, Penelope can monitor the data being completed to raise alerts or trigger workflows if – for example – a client’s score or score classification in a given smart form or assessment reaches a certain agency-defined threshold or – ingeniously – if the change in score for these documents over time reaches a certain threshold.
In other words, with all of these documents flying back and forth – amidst a mass of other (often chaotic) work – it is often easy to overlook some warning signs, to make sure appropriate parties are notified and to take appropriate, considered action.
Penelope remains vigilant and can make sure none of these warning signs or client well-being metrics go unheeded and as such provides an immensely valuable clinical service in support of maximizing value-based care in the context of reduced administrative costs.
It is important to note that the technology in no way replaces clinical judgment (for obvious reasons), it merely supports informed decision making, adherence to timeframes in an often hectic work schedule and a sense of standards-based accountability.
Because outcomes of service are tracked in a multi-dimensional manner along with the inputs (actions and timescales), an agency will be able to have powerful, evidence-based insights into what is working and most critically – why!
These insights can then be used to further refine prescribed actions in a virtuous circle of continuous improvement with the resulting improved client outcomes and reduced administrative burden.
In short – everybody wins!
Would you like to learn more about how Penelope case management software’s automated workflows can help transform your agency? Contact us, and an evaluation specialist will be in touch!
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