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Provide access staff momentum even when salaries remain stagnant
Invest in your front end
It's no secret that the responsibilities and skill level of most "front end" staff have expanded greatly, while financial compensation has typically not kept pace. As a result, "patient access staff will demand higher salaries," predicts Antionette Anderson, CHAA, CHAM, director of patient access and centralized scheduling at Skaggs Regional Medical Center in Branson, MO.
"Patient access is now the upfront business office," says Anderson. "They have to be recognized for what they do. We have to invest in patient access staff, just as in the past we did this for the back end."
a.derson says that across the country, recognition of the importance of front-end staff is beginning to grow. "It is very important that the director of patient access fight for this, and the CFO understand exactly what the front end does," she says. "If not, staff will move on to other departments."
Stop staff from moving
To promote staff development within her department, Anderson created a career ladder with five rungs. Each rung increases the employee's hourly wage by 25 cents, she says, except for the fourth, which gives a 40-cents hourly increase, and the fifth, which gives a 50-cents increase and requires passing the Certified Healthcare Access Associate (CHAA) examination, for a maximum total increase of $1.65 per hour.
"The first three rungs can be attained in their first year of employment, the fourth in their second year, and the fifth ring in their third year," says Anderson. "They have to maintain all of the rungs."
a.fellow employee has to recommend an employee for the career ladder, explains Anderson, and his or her immediate supervisor must provide written justification.
a.derson notes that the hospital pays for the CHAA examination, and provides staff with the right tools such as accuracy software, electronic insurance verification tools, and cost-estimator software. "I think this is very important, as their salaries are stagnant," she says.
Invest in front end
Paige Bohannon, director of admissions at Hendrick Health System in Abilene, TX, says that staff retention has been a challenge in her department. "Our main challenge is keeping the college students that we hire engaged in the job," she says. "They are willing to do the odd shifts for a while, like working weekends and night. But sometimes they lose interest."
Bohannon retains employees by making them feel like they truly belong. "It is harder to leave when you feel like you are a part of a group or a family," she says.
Staff in the various patient access/registration areas have the opportunity to move up the department's career ladders as they master different levels of their job, Bohannon explains. "Also, they have the opportunity to move within the department, to learn different aspects of the department," she says. "Scheduling, insurance verification, patient placement, and admissions are all very different."
Bohannon cross-trains her staff as much as possible, giving them the chance to try out working in the ED and outpatient and diagnostic areas, and working with direct admits and patient placement. She hires temporary "floaters" who are trained in all the different areas.
"Usually, those floaters will take a full-time position when it becomes available," says Bohannon. "It also gives the floaters an opportunity to see all the areas and choose which area they enjoy best."
Bohannon does her best to show her staff that in patient access, "the opportunities are endless." Lead and supervisory positions are offered for the different shifts and areas, she notes.
The hospital's career ladder is based on length of employment, dependability, quality, and productivity, says Bohannon. "Everyone participates. It's not real formal they don't have to apply to participate," she says.
Several employees have started at the entry-level position and worked their way up to supervisor and even director, reports Bohannon. "One of our current supervisors has worked here for 12 years, all in patient access," she says.
This man began his career as a representative in the trauma center, then went over to the center for rehab, came back to the trauma center as the lead rep, was promoted to trainer, and is now supervisor over trauma admissions and patient placement, says Bohannon.
While positions in patient access don't require a degree, most other positions within the hospital require either a degree or certification, notes Bohannon. "Our positions are not always looked at as a 'career' position. We have to promote that." Here are some changes Bohannon made to improve retention:
A "morale committee" was created.
These individuals organize snack days and pot lucks during work, as well as annual picnics and Christmas parties outside of work, says Bohannon.
Each employee receives a bookmark that lists his or her good qualities, such as "smart," "professional" or "conscientious."
A "You're a Keeper" card is filled out by patients if they encounter someone who is doing a great job or going above and beyond.
"This is read to staff during quarterly department meetings," Bohannon says.
Two employees are featured each month in the hospital newsletter.
The entire staff are bought dinner when quarterly goals are met.
In general, Bohannon says that she makes a point of focusing on an individual employee's strengths. "This ensures they are placed in the appropriate positions," she says.
[For more information, contact:
Antionette Anderson, CHAA, CHAM, Director of Patient Access & Centralized Scheduling, Skaggs Regional Medical Center, Branson, MO. Phone: (417) 335-7701. E-mail: AGAnderson@Skaggs.net.
Paige Bohannon, Director of Admissions, Hendrick Health System. Abilene, TX. Phone: (325) 670-2000. E-mail: firstname.lastname@example.org.]