Focus on certification helps staff morale, retention

AR days also positively impacted

Looking for a way to retain staff and enhance training, the patient access leadership at Delnor Community Hospital in Geneva, IL, turned their focus to the professional certifications offered by the Washington, DC-based National Association of Healthcare Management (NAHAM), says Karin Podolski, RN, MSN, MPH, CHAM, director of patient access.

After Podolski and a registration team leader got the Certified Healthcare Access Manager (CHAM) designation in 2005, they decided to offer front-line staff the opportunity to take the Certified Healthcare Access Associate (CHAA) examination as a way of increasing the professionalism of the department, she adds.

The results have been extremely positive, says Podolski, who credits participation in the program with a significant decrease in staff turnover and increase in employee morale, as well as a dramatic reduction in accounts receivable (AR) days.

Comparing fiscal year 2005, when the program started, with fiscal year 2006, turnover has decreased from 28% to 11%, and employee morale increased from 63% to 78%, as measured by Sperduto & Associates, an Atlanta-based firm of corporate psychologists and management consultants.

The decrease in AR days — from 74 days to 40 days — during the same period, Podolski suggests, is related to an increase in registration accuracy due to all the reviewing of revenue cycle material.

Because of the amount of certification that goes along with her nursing background, the decision to seek credentialing for her staff was a natural progression for her, she says.

She knew, however, that she would have to sell the idea without the promise of increased compensation because Delnor does not provide a financial incentive for obtaining certification, Podolski adds. "I knew that would be a hurdle."

The kickoff meeting for the program was held in the fall of 2005, and the access department trainer — who passed the CHAM exam that year and also became certified to proctor the examinations — took applications from 32 of Delnor's 110 access employees, Podolski says. Except for a couple of employees who left for various reasons and one who "kept putting it off," all the applicants took the exam, as required, within the following year, she adds.

The employee who let the year deadline go by had to pay back the exam fee — which the hospital pays for all applicants — and the fees for the two employees who left were transferred to others within the department, Podolski says.

The trainer sets up a time each month to offer the exam, which is taken with paper and pencil, she notes, and mails the completed tests to NAHAM. The exam can be completed on-line, Podolski explains, but that practice was discontinued at Delnor, she says, "to reduce the potential anxiety of finding out the results while in a room with peers and to reduce any anxiety staff may have about taking a test on-line."

Four people did not pass the exam the first time, Podolski notes, and the department sent flowers as consolation. They were successful on the second try, she says.

The second year of the program, which is in sync with the hospital's fiscal year, began with a party in October 2006, where 14 more employees applied to take the CHAA exam by the end of August 2007, she says.

That event also was a celebration of the success of the previous year's applicants, Podolski adds. Staff from clinical areas were invited to join their access colleagues in the celebration.

Those who obtained the certification also were recognized with a certificate to hang in their work area, a congratulatory card from the hospital's chief financial officer, and a pen provided by NAHAM, she says. "We also put their names in the employee newsletter, and sent out an e-mail listing the employees and talking about NAHAM and what the certification represents — that it promotes respect for the department and professionalism."

In addition, the CHAA credential is designated on the employees' name badge, Podolski says. Although the certification is not linked to an increase in pay, she notes, it does figure into an employee's annual review.

"There is a 'growth' goal, and the only way to get a [top rating] on it is if the person is certified," Podolski adds.

Even two college students who work in the department — with no long-term access career plans — opted to take the exam, she notes.

Money is not the biggest motivator for this kind of achievement, Podolski says. "It's recognition and support and validation, the fact that [a CHAA] is not just a registrar at Delnor, but a certified access associate. If they move to another area, they have this foundation to hit the ground running and find another position."

(Editor's note: Karin Podolski can be reached at karin.podolski@msn.com.)