Not just a good, but great first impression

If registration goes smoothly, that great experience is going to carry through the rest of the patient's stay, according to Betty Bopst, director of patient access at Mercy Medical Center in Baltimore, MD.

"We are the ones they see first. We want to build loyalty. If we do that, the patient is forgiving of our mistakes because they are loyal to us," Bopst says. "But if things don't go well, you can ruin it on the front end."

At St. Rose Dominican Hospitals in Henderson, NV, if a procedure must be delayed for the patient's safety or other unavoidable delays occur in registration areas, registrars explain the reasons for this, says Natasha R. Meinecke, interim patient advocate. "Our patients have shared that they appreciate our honest communication," she says. "If a patient is waiting for a procedure or hospital bed, we make every effort to meet his or her expectations while he or she waits."

Patients and loved ones might be fearful, in pain, or frustrated as a result of their healthcare needs, says Meinecke. "It is important that registrars are sensitive to those needs, expressed and unexpressed, by truly connecting with our patients," she says.

Registrars offer comfort items such as extra pillows and blankets, as well as eye masks and ear plugs to help reduce sound and light, says Meinecke. "All of these items promote a more healing, restful environment," she says.

Patients might quickly become frustrated at registration, such as when he or she doesn't realize you need to quickly verify their identity so that you can locate a prior medical record number, says Bopst. "To this day, the objectives of registration are still very misunderstood," she says. "It's not all financial. The bigger piece is for us to identify that person without a shadow of a doubt."

Patients might insist they have no existing records as they haven't been to the hospital before, but a medical record would have been created for them if there was previous labwork or an outside film was sent in for interpretation, says Bopst. "If a patient tells us, 'I've never been here before,' we don't just take that at face value," she says. "We continue to do our search to see what we can find."

Registrars at Mercy Medical Center take these steps to make a great first impression:

• If patients have to wait for a longer time, registrars go down to the emergency department to obtain warmed blankets to make them more comfortable.

"That is something that patients really appreciate," says Bopst.

• If it's around meal time, registrars contact the patient's doctor to see what they can have to eat, and they will get a meal for the patient and whoever is accompanying them.

• If a patient leaves on a bad note, staff members check in with them later.

"With certain patients, you have to give up on getting the information and wait until they get to their room later in the day," says Bopst. "If a piece of information is missing, we can then try again and see if we can pick up a little something else."

Even if no information is needed, Bopst says her registrars have found that patients like being checked on to see how they are feeling.

• If a patient seems to be waiting too long for transportation, a registrar transports them.

"We'll put them in a wheelchair and take them up right to the room," says Bopst.

• Relationships are formed with "regulars."

Patients like to feel as if you have more of an interest in them than just getting their social security number, says Bopst. "We have a lot of frequent fliers here," she says. "People like to be recognized, and they like to be known."


For more information on improving patient satisfaction in registration areas, contact:

Betty Bopst, Director of Patient Access, Mercy Medical Center, Baltimore, MD. Phone: (410) 332-9390. E-mail: