At Wheaton Franciscan Healthcare in Glendale, WI, pre-registration staff members are cross-trained in the main registration area, the emergency department, and front desk walk-in registration, says Kim Gehl, manager of patient access in central scheduling and central precertification.
"We can move associates from one job function to another, wherever the volume and need is the greatest," says Gehl. Significant cost savings come from not hiring additional staff to fill shortages due to vacation and sick calls.
At Mercy Hospital — Springfield (MO), the patient access team supports a dozen outpatient locations. "Some of those only have one coworker due to patient volumes," says Natasha Acra, manager of outpatient patient access.
Each employee is expected to be trained in at least two outpatient areas; some are trained in all 12. "This gives us more flexibility when a team member calls in sick," says Acra. "Even on short notice, we can find someone that is able to work an open shift much easier than if they weren’t cross-trained."
Staff members cover any area that has a sudden surge in volume, which eliminates the need to call in additional staff. "We are able to save costs by needing less FTEs in the outpatient department. We have only one PRN coworker and typically have no overtime," says Acra.
Cross-training also eased the stress of staffing areas with only one registrar, when that person was out. "Previously, few people would be familiar with the location and not able to cover it with short notice," says Acra.
Staff keep their registration skills in each location sharp by rotating shifts. "We give them the chance to work in each location once a month or so," says Acra. (See related stories on metrics used to ensure adequate staffing, p. 124, and a training program that gives staff knowledge of the entire revenue cycle, p. 125.)
Expanding access role
Patient access areas at Robert Wood Johnson University Hospital in New Brunswick, NJ, previously relied on part-time and per-diem staff members to support staffing shortfalls. "However, the expanding role of the access staff makes maintaining competencies of these individuals a challenge," says Kathleen B. MacGillivray, MHA, director of access management services.
Staff members are now rotated throughout the department. "We run quality checks on their work to ensure they meet the standard," says MacGillivray.
Managers do this quality check with a report card that includes patient demographic and insurance information, including Medicare as Secondary Payer completion and Medicare Notice compliance. [The report card is included with the online issue. For assistance, contact customer service at email@example.com or (800) 688-2421.] "Department accuracy is greater than 95%," MacGillivray reports. "Cost savings come by way of efficiencies in patient throughput, as well as reduction in rework."
The pediatric emergency department now has an average registration turnaround time of less than 10 minutes. "This positively impacts overall patient throughput," says MacGillivray. "Overtime is less than 1% of our salary budget."
Natasha Acra, Manager, Outpatient Patient Access, Mercy Hospital — Springfield (MO). Phone: (417) 820-9899. Email: Natasha.Acra@Mercy.net.
Tinnie Garlington, CPAR, CFC, CHAA, CHAM, EHI Quality Assurance/Training Supervisor, Emory Healthcare, Atlanta. Phone: (404) 251-3910. Email: firstname.lastname@example.org.
Kim Gehl, Manager Patient Access, Central Scheduling and Central Precertification, Wheaton Franciscan Healthcare, Glendale, WI. Phone: (414) 527-5010. Email: Kim.Gehl@wfhc.org.
Kathleen B. MacGillivray, MHA, Director of Access Management Services, Robert Wood Johnson University Hospital, New Brunswick, NJ. Phone: (732) 937-8909. Email: Kathleen.MacGillivray@rwjuh.edu.