Employee education big part in initiative's success

Important Message part of all staff meetings

Putting the "know" before the "why" for patient access employees was the focus at Stevens Hospital in Edmonds, WA, during implementation of its procedure for distributing the revised "Important Message From Medicare," says Evita Armijo, patient access manager.

"It's not just the operational process, but the education process," she adds. "It's about being responsible to educate [employees] on what the ramifications are if we don't have [the Important Message].

"What we've done," Armijo says, "is give them reading materials, a written procedure, the actual pieces from the manual that the Centers for Medicare & Medicaid Services provides of the regulations and rules. We've built a little packet for registrars."

Patient access staff must sign a form, filed as part of their education records, stating that they have read the materials, she says.

Additionally, ongoing education related to the Important Message always will be on the agenda — "part of our 'Pillar for Quality'" — of departmental staff meetings, Armijo adds. "We talk about how well we're doing and what types of obstacles we're running into. We brainstorm together as a group on how we can improve the processes."

At present Important Message procedures are mostly manual, she says, built around the limitations of the hospital's existing computer system. A new system is scheduled to be installed in the summer of 2008, Armijo notes.

"We do get a report every day from information systems with the names of all Medicare patients that are in-house," she says. "One of the patient access coordinators goes through those names and makes sure that a signed copy of the Important Message form is scanned and in the record for those patients, and that we have a good communication process to follow up if some patients have been missed."

When patients are missed, Armijo notes, it is usually because they were admitted through the emergency department.

With the installation of the new computer system, she says, there likely will be alerts or perhaps a screen process whereby registrars can't go to the next page of the registration process without taking care of the Important Message.

The new system might also print the forms on demand, Armijo adds, eliminating the need for NCR forms.

Sooner than that, she says, the hospital plans to add Korean to the languages — now English, Spanish, and Russian — in which the Important Message is distributed.