Phone Tree Baseline Data (Dec 2015) More than half of all calls to PH line do not use the phone tree *Anecdotally, most ‘zero out’ calls are for STD services, immunizations, or are transferred to environmental health services (e.g. mold, food handling, water, air quality etc.) Of those who use the phone tree, most are calling for STD/HIV STD = 126 HIV = 4 TB = 31 Other = 55

Sampling of ‘Zero Out’ Calls (Mar 2016) MCDPH Staff answering the operator line between March 2nd and March 11th categorized ‘zero out’ calls by type using a check sheet. This sampling period included two 4 hour AM shifts, two 4 hour PM shifts and six 1 hour and 15 min lunch periods. Call Type: Total Calls: 3/2/16 pm 3/3/16 Lunch 3/4/16 Lunch 3/7/16 Lunch 3/8/16 AM 3/8/16 Lunch 3/9/16 AM 3/9/16 Lunch 3/10/16 Lunch 3/10/16 PM STD/HIV 67 10 1 4 13 12 Other Environ. Services 2 6 Miscellaneous 3 Tuberculosis Child Immunizations Adult Immunizations 5 Food Handlers Card Primary Care Services Vitals Foreign Travel/Refugee WIC Tobacco Oral Health Pharmacy DES

Info about HealthCare Srvcs Public Health concerns 0. Operator Project AIM By May 31, 2017* less than 10% of callers to the main public health phone line will select the ‘zero out’ option. *Note: due to implementation delays the goal date was extended from the original target of May 31, 2016 The Revisions (April 2017) PH Emergency PH Services Other County Info about HealthCare Srvcs Public Health concerns 0. Operator STD Immunizations Environmental Vitals Other Clinic PH Services Admin PH emergency

Phone Tree Data Post Revision (May 2017) Only 4% of all calls to the PH line tried the ‘zero out’ option 27% of all calls to PH line did not use the phone tree This represents a 14% increase over baseline data Project Aim of <10% achieved

Sampling of ‘Zero Out’ Calls (May 2017) MCDPH Staff answering the operator line between May 2nd and May 9th categorized ‘zero out’ calls by type using a check sheet. This sampling period included two 4 hour AM shifts, two 4 hour PM shifts and six 1 hour and 15 min lunch periods. These results were compared to baseline data gathered in March 2016 Additionally, key staff representing 6 areas that answer calls representing options on the main menu of the revised phone tree were asked about change in call volume and ‘errant’ calls via survey a few weeks after implementation. Key insights are summarized below: The respondent that fields calls for WIC and other Community Health Programs reported a dramatic increase in calls, although the burden is only about 6 calls a day. The other 5 areas reported that call volume either stayed about the same or decreased slightly. No one felt that the change has negatively impacted their unit’s ability to provide good customer service although a few mentioned it would be nice to have a list of frequently called numbers they could use to transfer the few ‘errant’ callers quickly and efficiently. The STD/HIV clinic – which has historically had the highest call volume from this phone tree- reported that they were receiving less calls from individuals looking for other services. ‘Errant’ calls that were received by two other units (TB/Refugee and WIC/Community Health Programs) were for a range of issues and one respondent observed that “It mostly seems to be people who don't know what buttons to push and are randomly just trying to get someone... anyone to answer their call.”