Proactive registration dept. leads to hospital’s award

Patient satisfaction, physician efforts cited

When Southern Ohio Medical Center in Portsmouth received the Ohio Award for Excellence (OAE) in September 2002, indications are that it had a lot to do with the hospital’s proactive registration and central scheduling department.

Outlined in the application for the honor — awarded each year to a winner selected from just one of five categories, including business, education, government, health care, or not-for-profit — were several registration initiatives and achievements, explains Pam Partlow, RN, manager of central scheduling and registration.

Mentioned in the award-winning application were the quarterly breakfast that she hosts for the staffs of physician offices and nursing homes in the area, and a newsletter that Partlow writes and sends to physicians each quarter.

Three of the hospital’s registration areas had achieved a 99th percentile ranking from South Bend, IN-based patient satisfaction measurement firm Press Ganey, which also was noted in the application, Partlow adds. Wait time in the emergency department (ED) went from a 50% satisfaction ranking to a 99% score, she says, while the hospital also ranked in the 99th percentile in courtesy of registration.

In the category of registration wait time, she notes, the hospital went from a 16% ranking to
an 87% ranking.

Other measurable indicators include the monthly accuracy rate for registrars or schedulers employed six months or more, for which the goal is 97%, Partlow adds.

Bedside registration boosts score

The primary reason for the dramatic improvement in ED wait times was the implementation
of bedside registration about two years ago, she says. Staff now do more than 3,000 ED registrations a month at the bedside using four laptops — three are ready-to-use computers and a fourth is charged for backup, Partlow adds. The department surpassed its goal of 3,163 registrations (using laptops), reaching 3,465 in the third quarter of 2002.

The laptop on wheels is nicknamed Rosie (named after robot maid from the old Jetsons television show), she notes. When doing presentations on ED bedside registration for staff from other hospitals, Partlow says, she often lifts Rosie up and puts an apron on her. "We believe in having fun while we work in our organization." Other laptops are known as R2D2 (from the Star Wars movie series) and Johnny 5 (from the movie Short Circuit), she says.

"The number of bedside registrations performed in this manner depends on bed availability," Partlow notes. "We could do more if more beds were available." The figures cited are just for bedside registrations using the laptops, she points out. "We have other means of doing bedside registration." (See graphs.)

Total bedside registrations are not recorded by volume, but rather as a percentage of all ED registrations, Partlow explains. For the last quarter for which figures were available, 41% of registrations were at bedside, with a goal of 50%, she adds.

The hospital approximately has 13,000 ED visits a month, Partlow says, many of which do not require the use of a bed because the patients need only minor treatment.

Partlow credits monthly meetings of a multidisciplinary performance improvement team and the support of the ED medical director for the success of the bedside registration initiative.

"Everyone has to be on board," she says, "including nurses, X-ray technicians, and physicians."

One of the things she also highlights in her presentations is the importance of staff buy-in, Partlow adds.

"It finally dawned on me that just because managers think an idea is wonderful, it doesn’t mean staff necessarily want to follow," she says. "You’ve got to be a cheerleader and set targets for them." In her case, she says, that meant creating an atmosphere of excitement at meeting an initial goal of 50 bedside registrations a month.

Partlow says she recently completed an application indicating she would donate her time and that of her supervisors to present "best practices" under the auspices of the Ohio Award for Excellence program.

"I applied for wait-time in registration,’" she adds. "We could present at OAE sessions or at other hospitals."

[Editor’s note: Pam Partlow can be reached at (740) 356-8885, ext. 8885 or by e-mail at partlowp@somc.org.]