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Does turnover keep you up at night? Try these tips
Do you want to discourage staff, send a registrar's morale plummeting, and as a result, deal with higher turnover in your department? If not, don't make these morale-busting mistakes:
Failing to say a simple thank you.
"Staff want to be recognized. Oftentimes, a simple thank you goes a long way," says Holly Hiryak, MNSc, RN, CHAM, director of hospital admissions/access services at the University of Arkansas for Medical Sciences in Little Rock.
What you're thanking staff for doesn't have to be anything earth-shattering. You can thank an employee for offering to help out a co-worker who is busy or having problems with a task, working additional hours when needed, or adjusting his or her shift to accommodate department needs. "Compliment them on their smile or say, 'Thank you for smiling,'" suggests Hiryak. "This helps them remember to smile."
Failing to remember special dates.
At SSM Health Care in St. Louis, the patient access department created its own registration newsletter that recognizes birthdays and anniversaries of employees, among other things. "Staff appreciation and recognition helps keep morale up," says Jayne Wright, patient access director of the organization's North Operating Group. "Having a strong support system does, too."
"It is important that you recognize days that are important to your staff, such as birthdays or anniversary dates," says Hiryak. "I also send Christmas cards to their home. It's about recognizing them as being a person and giving them respect."
Hiryak sends cards to employees on their birthdays and also sends a "thank you for being on our team" certificate to their home to recognize their anniversary date.
To remember these dates, Hiryak relies on the hospital's HR system, from which she runs monthly reports. Her administrative assistant prints out a list of birthdays and anniversaries, and Hiryak addresses and signs the cards. Also, a monthly birthday flyer is printed and posted, so everyone knows who is celebrating a birthday.
Sherri Pitkin, associate director of patient access management at University of Iowa Hospitals & Clinics in Iowa City, says that "the pre-access people have a monthly birthday treat day and a wonderful bragging board. Each person has a brief bio with their picture."
One employee is spotlighted each month with that person's choice of picture, such as his or her family or a wedding photo, hung on a large poster board by the "bragging wall." Co-workers are invited to comment and write on the board.
"For a call center, it has turned out to be a great way to get to know people even when the time to socialize is so short," says Pitkin.
Focusing only on the negative.
"I have found, in my many years, to praise, praise, praise what they do right," says Wright. "With the thousands and thousands of registrations that they do every day, they get blamed for almost everything that can go wrong. Because we are the first step in the revenue cycle, we impact almost everything."
Provide a minimum of monthly, preferably weekly, feedback to every staff member, recommends Pitkin.
It doesn't matter if the staff member is a low or high performer, says Pitkin. "They all need face-to-face time with their supervisor or manager. This takes a very few minutes."
Pitkin recommends being "brutally honest" if there are deficiencies. It's not enough, however, just to tell someone to improve; you need to provide a personalized action plan for this employee.
"Observe the employee's workflow. Use a checklist of duties to find the staff's comfort zone and those areas where they are unsure," says Pitkin. "Most employees know their own weaknesses. If approached positively, they will become a driving force in their own improvement."
When coaching employees on how to improve, Pitkin says to focus on the effect they have on the patients. "Impose solid deadlines for the improvements. Follow through, and celebrate every accomplishment," says Pitkin.
Front-end staff need to know how they affect the entire revenue cycle and the individual patient, so "give the whole story in small bits," says Pitkin. "Explain that improvement in denials, cash collections, and satisfied patients are the end result of their work."
A staff committee allows employees to bring forth their own issues to management, either anonymously or as part of a group. "Staff need to be heard," says Pitkin. "The committee reviews the problem to make sure it really is an issue and helps the person come up with expected outcomes and viable solutions."
"Never reprimand staff in front of their peers," says Hiryak. "If someone is underperforming, we do work with them to point out where they could improve. But it is important to note where they are doing well."
For example, a staff person's accuracy may not be where you want it, but when you point this out to the employee, don't forget to mention his or her great customer service skills. "We would coach and council the staff on accuracy, and recognize those customer service qualities," says Hiryak.
Giving your best performers a heavier workload.
Keep staff workload as even as possible by tracking the productivity and quality of individual staff members, advises Pitkin.
"Good performers will often get more work. I have seen this happen all too often, and this can be a morale buster as well," says Hiryak.
For employees who exceed Hiryak's expectations, she makes a point of thanking them publicly, in front of their peers. "This lifts everyone's spirits," says Hiryak. "It gives those not performing well an opportunity to see the positive recognition that they can work toward."
Ignoring issues brought to your attention.
Pitkin says that both good and bad performers must be addressed by patient access managers. Whether it is a staff person featured on the "bragging wall" or a complaint raised by the staff committee, both must be paid attention. "Issues brought up and ignored causes lower morale and resentment," says Pitkin. "Give an answer on each and every issue, even if the answer is no."
Pitkin says that timing also is an issue. "Address all issues quickly and follow through to make sure that the outcome is as expected," says Pitkin. "Seemingly small issues corrected quickly really boost morale, gain the employee's trust, and just make you feel good."
[For more information, contact:
Holly Hiryak, MNSc, RN, CHAM, Director, Hospital Admissions/Access Services, University of Arkansas for Medical Sciences, 4301 W. Markham, Little Rock, AR 72205. Phone: (501) 686-8170. Fax: (501) 603-1243. E-mail: firstname.lastname@example.org.
Sherri Pitkin, Associate Director, Patient Access Management, University of Iowa Hospitals & Clinics, 2305 University Capitol Center, Iowa City, IA 52242-5500. Phone: (319) 384-2323. E-mail: Sherriemail@example.com.
Jayne Wright, Patient Access Director, North Operating Group, SSM Health Care, St. Louis, MO. Phone: (636) 625-5479. Fax: (636) 755-3869. E-mail: Jayne_Wright@ssmhc.com.]