Learn whether service is first-rate, or far from it

Your patient access staff are responsible for the patient's very first impression of the hospital. "If something does not go right in the patient access area when the patient arrives, then it sets the tone for any other department treating that patient," says Rose DiLuzio, patient access manager over ER registration, outpatient, and admitting at St. Vincent Health Center in Erie, PA.

To assess the service provided by staff, use these approaches:

• Measure wait times.

At Bronson Methodist Hospital in Kalamazoo, MI, department managers constantly measure the number of calls coming in and how long before each call is answered.

"We don't want people to wait," says Patti Burchett, director of registration and central scheduling. "In outpatient testing areas, managers track how long it took for patients to get registered and then to get back for their test, or door-to-floor."

If something is inhibiting customer service, Burchett says staff members are encouraged to make changes themselves. "We call that a 'just do it,'" she says. "The people who do the work know more than anyone what needs to happen to make an improvement." In the ED, registration forms might not be organized in a logical manner, she explains, or a scanner or printer might need to be moved.

• Observe staff.

Lynn Craven, patient access director at St. John Providence Health System in Warren, MI, says that face-to-face observation gives her the chance to provide feedback and acknowledge an associate while "in the moment." "This serves as a motivational tool for continued growth," Craven says.

Bronson Methodist's process improvement department does observations for patient access areas occasionally, says Burchett. "They observe wait times and process. Sometimes staff know they are watching, and sometimes they don't," she says.

DiLuzio observes staff by sitting in an adjacent registration booth and listening to the conversation taken place. "We try not to let the patient access associate know we are monitoring this," she says.

Patient access staff members are observed almost daily in the emergency room (ER) and less frequently in the admitting and outpatient areas. "I have a team leader in the ER that is a hands-on individual," says DiLuzio. "He is constantly monitoring staff for productivity and any types of patient concerns that arise."

• Use secret shoppers.

Craven says that in her department, hospital associates as well as managers' own family members have been used as secret shoppers.

On occasion, "secret shoppers" have been used in the ER at St. Vincent to help evaluate an associate with a pattern of inappropriate behavior. "This is not a problem we experience frequently," says DiLuzio. "My staff knows that I do not tolerate behavior that will make a patient uncomfortable or not want to come back to our facility."

• Record phone calls.

This recording allows managers to assess how the registration staff is interacting with customers, says Burchett.

"Right now, if a customer has a concern, we review the recorded phone conversation. There may be an opportunity to coach the individual or to clarify an item for the team," she says.