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Standing by for
your medical call Day and night, rows of
operators site ready to direct thousands of calls. For some who ring, the
news is grim. The man on the phone was desperate, his words fast, anxious. He needed to page his doctor, he said, needed to page him now. He was terminally ill, he said - just diagnosed - and he was still young. The emergency call operator typed the doctor's name into his computer. But the screen said unavailable; the doctor was not accepting pages. The man on the other end burst into tears. The operator made a split-second decision. He called the doctor anyway. "We make decisions like this everyday," said Gary Condit, who took the call. "People who work here work to help people. They're ready to take risks." Taking up to 15,000 calls a day, the MASCO Services Customer Care Center in the Longwood Medical area calls and coordinates paging for Beth Israel Deaconess Medical Center, Dana Farber Cancer Institute, Emmanuel College and about 200 private medical practices. It is part of a consortium called the Medical Academic and Scientific Community Organization. Though the Care Center's been in existence since 1976, its technology has certainly evolved over the decades. With more than 6,000 active pagers in the network, 30 call center seats for live operators and automated equipment such as interactive voice response and speech recognition technology, the center is a small miracle on the edge of modern medicine. "Basically, MASCO is the front door to these organizations, the first voices people hear when they call," said Jim Conway, the senior vice president and chief operations officer of Dana Farber. "Those who call in have often just heard the worst possible news a person can hear, operators have to take that into account. The operators are the first experience people have with Dana Farber; we trust them to get patients the care they need and to use good judgment." For customer care representatives, as the call center operators are officially called, it's not just a question of judgment, but of juggling. "There's an incredibly wide range of things our reps need to know," said Gary DuPont, the service's director of telecommunications and customer care. "We answer calls from so many different institutions. One minute, it could be a cardiac arrest, or dispatching the trauma team for an area emergency, or it might just be a confused patient needing dialing assistance or a doctor's number. We have to train for everything and anything, and then some." With such high stakes one might guess a day at the call center would resemble "ER" - phones ringing loudly off the hook, operators breaking into cold sweats, people running about the building. But for the most part, the center is remarkably quiet - more subdued than a phone-a-thon or pledge campaign on TV. Typically 10 or 12 customer care representatives and their supervisors sit in front of computer terminals, talking calmly into their headsets. Day and night, call center representatives sit in four long rows of workstations, the partitions between them just high enough to see over the top when seated. Calls from all the member institutions and private practices ring at each individual work station, triggering the computer screen to flash the name of the hospital, university or office the caller has dialed, and the protocol for answering that institution's call. In a half-hour's time on a recent weekday morning, calls came in requesting a Vietnamese translator for an incoming patient; a man needing to reschedule a doctor's appointment; a woman canceling hers. Hospital managers faxed updated schedules for their on-call departments; doctors called in for messages. At the center of the room, three people are designated to answer the "code phones," special lines equipped to receive and record emergency calls. When those numbers are dialed, a brief alarm - a quiet, cricket-like chirp - sounds once throughout the call canter and automatically alerts the managers. On this day, four codes came in within three hours: an adult code blue - cardiac arrest; a request for a trauma team at Beth Israel Deaconess; a wrong number, and a test of the center's reflexes, conducted by Dana Farber. In each case, the reps handled the calls quickly and calmly; to an onlooker it wasn't apparent which were the real emergencies. But even with concerted efforts to track performance levels, the Care Center, like any organization, can encounter difficulties. "For us, the trouble is not usually technological," said Jeff Johnson, a project manager. "One of the cardinal mistakes is if an operator answers a call intended for Dana Farber, for instance, but accidently uses a Beth Israel Deaconess greeting. These types of things don't happen often." At the front of the room in the call center, there is a lighted "scoreboard," which registers how many calls are currently holding, how long they have been holding, and how many calls have been answered within 20 seconds, or about 3.5 rings. "The goal is to be at or above 85 percent," said Mary Gaughan a senior telecommunications analyst and supervising manager. Glancing up at the scoreboard, she nods at the 96 percent gleaming in red. "Good timing," she says. "But it's all based on agent availability, call volume, and how difficult the requests for service are....It's not always 96 percent." It definitely rated high, however, the night a fire broke out in a dumpster in the basement under the center three years ago. "The smoke was so thick we could barely see, but calls were still coming in and no one was in immediate danger. People were given the opportunity to leave, but no one did," said Alex Cwalinski, the lead phone operator that night. "We just made a unilateral decision to stay, answering calls through the smoke as firemen walked around." These days MASCO Services has several contingency plans for any local or national emergency. "Now all of our systems are redundant, we have alternate, undisclosed call center locations, and we have procedures to stay connected to the city and each other," said Sarah Hamilton, director of area planning and development. On Sept. 11 itself, MASCO members had a chance to see the value of the emergency preparedness plans. After activating a general alert, and announcing news briefings every two hours, the call center received many calls from medical personnel in the Longwood area who simply could not get straigtforward information about the number of casualties indliected by the terrorists' attack. "People kept seeing TV footage of patients being loaded onto planes destined for Longwood," said Hamilton. "No one knew whether it was true or not, and thus couldn't make plans to accomodate the patients. We contacted the Boston Emergency Medical Association, [which] contacted reliable sources in D.C. and New York, and got our answer in 10 minutes - patients were in fact not coming here." As for Condit, the operator who broke protocol when he contacted an off-call doctor with the just-diagnosed patient: "Turns out the doctor ws glad I did, he called me back to thank me." -------------------------------------------------------------------------------- Calls answered
in 2002: 3,638,421 --------------------------------------------------------------------------------
At pager central, my favorite call To the hardened operators at pager central in Longwood, some crises stand out. Here are a few: Alex Cwalinski: "One emergency that sticks out in my mind was an orthopedic surgery patient who slipped and fell in a shower in a rural area in Latin America and dislocated an artificial hip. He was too far away frpm everything to get help, so we concerenced the Longwood doctor in with the patient by phone, and he told the man how to pop his hip back in on his own." John Hilliard, a customer care representative who's worked at the call center for nine months: "One time an elderly woman called up. All she said was, 'I am so so lonely.' You have no idea who is on the other end of the line. I tried to get her back to normal as quickly as possibile and contacted her doctor." Kathy Nollet: "I had my first call on the code phones this past week - I just started here a few months ago. It was a code white, an obstetrics code. It made me feel nervous and excited because I wanted to do everything right and it had something to do with a new-born baby. But when it was done, it was the biggest rush. You know what you just did proabably saved somebody."
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© 1998-2007
MASCO Services Inc. |
