Tânia Mesquita, 36, is responsible for the customer care area, for the clinical secretariat – and above all, for welcoming patients at the Champalimaud Clinical Centre (CCC). She has a degree in management, a master's degree in strategic marketing and a post-graduate degree in Health Unit Management. In addition to her work at the Champalimaud Foundation, she is in charge of the quality module in a postgraduate course at the Instituto Superior de Gestão e Administração (ISLA) in Santarém, where she teaches. Tânia has also actively participated in various medical field events, presenting the Champalimaud Foundation model of customer care.
For her, it is paramount to simplify the patient’s "journey" during their time at the CCC, from arrival to leaving the clinic. This sets the Clinical Centre apart from other healthcare providers, she says, and has a clear impact on people’s emotional state, whether they are patients or caregivers or families that accompany them in this process. The aim is to reduce stress and anxiety levels, which already run high in patients with a suspected or diagnosed cancer.
Currently, there are 80 to 85 people in the team she heads, including reception managers, who circulate around the waiting rooms to ensure patient well-being, and patient managers, who are embedded in the Clinical Units and Services and deal with scheduling and cost estimates, and liaise with insurers and health subsystems. "We have a great team for this great project," says Tânia Mesquita, adding that "this area of non-clinical care is scaled to the importance the Foundation attributes to it."
In what way is patient reception at the CCC unusual?
Our concern is that patients shouldn’t feel like they're entering a hospital, that they really have the chance to be with their family in a pleasant and peaceful setting, that they feel there are people at their side who make the process easier. It's a question of humanised, personalised care, tailored to each patient during a very delicate and vulnerable phase of their lives.
We reflect on patient experience in great detail, starting with their first contact with the Foundation, but also on how they access our services, how they get to the Foundation, how they get to the consultation area, the examination area or to their treatments. We are also concerned about patient mobility issues. Our mission, from the moment we know the patient has arrived, is to provide close support. While they are with us, they have to feel that there is always someone available to facilitate the process and that this person is entirely at the service of their well-being.
What does this support consist of?
In the waiting room, patients have to be comfortable, know that they can have a coffee and eat a cake in peace with their family, that if there are any delays someone will come and check if they need anything – that someone is concerned and looking after their schedule. We don't have a ticket system at the Foundation; this allows patients to be anywhere in the premisses – at the kiosk, in the tropical garden, without having to keep an eye on a monitor to find out if it's time for their appointment or if someone is waiting for them.
Patients receive a smartphone from the Foundation at check-in, given to them by a “reception manager” who approaches them on arrival. Thanks to this system, they can move around freely and go the lounge areas we have created, in a more hotel-like mode, so that they don't feel like they're in a hospital. When the time comes for their medical procedure, patients know that someone will call them on their smartphone and that an operational assistant will also come to meet them. We have to balance the technological component with the humanisation of care. In other words, we want people to feel welcome, to feel that there are people there to welcome them and accompany them throughout the process. We’ve eliminated the need for a reception desk: patients don't need to stand in a queue; in our view we're the ones who have to go and meet them.
The Foundation's clinical services are divided into functional diagnostic Units, such as the Breast Unit, the Digestive Unit, the Urology Unit, the Lung Unit, the Gynaecology Unit, etc. And each Unit has a team of patient managers. The patient manager is the person with whom patients will interact from the moment they are registered at the Clinical Center and have an appointment. The Unit's patient manager is the patient's person of contact in the institution; it is this manager that the patient will contact to confirm or request appointments. The patient manager is the link between each patient and the Unit, who accompanies them and provides support for all their requests.
Does the way patients are welcomed and accompanied at the CCC differ from what other hospitals do?
I believe that all hospitals have hospitality and welcoming criteria and try to make processes faster and more functional, that each institution has different strategies for approaching this issue. But actually, our model has been replicated in some institutions and that's something that we appreciate, because it ends up being a validation by our peers and a recognition by our patients. As for our strategy, given that the patients we receive are cancer patients, we take particular care to prepare things in a way that is less burdensome and easier for them. And while there are hospitals that limit the time each professional can devote to each patient, fortunately we don't have that kind of limitation here. Quality is not measured in time, but in the way the patient feels welcomed.
We also try to put patients at ease from a visual point of view: we wear denim uniforms and sneakers, which don’t have the formality of suit and tie; we try to have a more practical and relaxed look. For us, formality lies in complying with the rules of protocol, in the way we attend to our patients and address them, but we think that our dress code informality brings us closer to people.
Specifically, how do patients proceed from the first contact?
The first line of contact is the Call Centre. The call centre operators answer the phone and manage the requests that come to us by email and via our website. The Call Centre also includes a nursing team that is in charge of clinical triage. We want patients to come to a consultation that has already been prepared, where decisions will be made – and not to a consultation where they will be asked for additional exams and will have to come back for another consultation. We have to manage the patients' time and the time of our professionals.
The nursing team contacts people within 24 to 48 hours of getting their request, receives all the clinical information and makes the appointments. From the moment we make the appointment, each patient is assigned to a multidisciplinary diagnostic unit – for instance, the Digestive Unit – and there they are assigned a patient manager, as I've already mentioned. Even though we we do everything as a team, the patient always has a contact person.
How is the patient put in touch with this manager?
When patient receive the text message confirming their appointments, they also get the name and telephone number of their manager (this information is also available in our patient app, Champ@me). Even if it's not always possible to get through to that manager straight away, we make sure that someone from the team answers or gets back to the patient in good time. This is one of our personalisation criteria: that patients know someone is looking after their file and dealing with their requests.
We take care to know in advance whether each patient is coming by public transportation, and if they're driving their own car, where they are going to park it. Will they leave it in the parking lot or in the street? If they choose the latter option, we have transport trolleys in our garage, which circulate all day long and are driven by members of the ChampiHelp Team, made up of young people from the University of Lisbon (as part of a partnership between the Foundation and that University), who give support to incoming patients. Again, what's important to us is to have people permanently present at strategic locations in case a patient needs a wheelchair or help with transportation. We know that arrival at the Foundation, especially when it’s the first time, is one of the issues that worries patients, who already come to the appointment feeling anxious and sometimes by themselves. Having someone to facilitate the process on arrival reduces anxiety levels and helps the patient feel more at ease.
And from there?
Arriving at the entrance of the clinic, there is a team there that helps people find the services: the reception managers, also called circulating managers – who, equipped with a tablet, prevent patients from having to stand in line at the counters. The manager sits down with the patient in a friendly and comfortable place, does their check-in and hands them a smartphone.
When it's time for a consultation, an examination or a treatment, the patient is called by the operational assistants, as I've already mentioned, who pick them up in the waiting room and accompany them, for instance, to the doctor's office. In this relationship that we try to build with patients, the clinical team itself receives the patient at the office door and takes as long as necessary with the patient. At the end of the consultation, the patient leaves accompanied by a health professional, who takes them to their patient manager, who in turn will follow up on future appointments and any requests. Sometimes, a patient has just received bad news and we need to give them some privacy, to ensure that they have a moment to take in what they've just heard. In these cases, the patient manager can take the patient to a more comfortable area. It's a privilege and part of our mission to ease the burden of illness on that patient and his family.
Finally, when the patient has completed their medical procedures and is leaving, comes the check-out; no need here either to get a ticket out of a machine in order to pay. We are developing technological tools to make it easier to carry out all the operations associated with billing with the patient sitting comfortably on a sofa, including direct payment on our app.
Do you receive feedback from patients about their experience at the CCC?
We don't send out satisfaction or quality of service questionnaires. The feedback we get is given to us in person or in writing by our patients. We have the privilege of having direct contact with people, of being with them on a daily basis, of listening to their opinions and suggestions. Every day we are in the field and we understand the difficulties faced by our patients and their families, but also the challenges faced by our teams of professionals in guaranteeing such a humanised - I would even say unique – level of service. We make a permanent effort to keep our team focused on their mission: to be at the service of the patient, to provide a service of excellence. To do this, putting ourselves in the patient's shoes is fundamental – to know what they need, what they value at each stage. Being part of this process is not always easy, but knowing that we have made a positive difference is just as motivating as our patients’ recognition.
Interview by Ana Gerschenfeld, Health & Science Writer of the Champalimaud Foundation.
