Hear a complaint? Don't jump to conclusions

Hear out your employee first

If a patient complains that a registrar seemed to care only about money, or insists he or she waited way too long to be registered, Jan Fowler, director of patient accounting at Saint Vincent Health Center in Erie, PA, makes a point of meeting with the staff person involved to hear their side of it.

Fowler also does some additional research to get the facts. "If it's something quantifiable, such as wait times, I will monitor a log that's kept for these purposes by the front desk greeter," says Fowler.

If the complaint involves a registrar's conduct during a patient's registration, such as their demeanor during co-pay collection, Fowler might sit in an adjoining cubicle to hear the registrar's interactions. Fowler says that by taking this step, she learned that it was unrealistic to expect staff to intuitively know how to collect money from patients, when that wasn't what they were hired to do. "There was a realization that there was a lack of training for some of the staff, so we went back to the drawing board," she says.

Fowler has also observed potentially problematic exchanges, even when associates have no idea they're offending anyone. In one such case, she fielded some complaints about a registrar who often said, "I pray to God that your medical treatment is successful," because some patients didn't appreciate hearing something religious.

"Working in a Catholic institution, she felt she was doing her duty by saying this," says Fowler. "We had to advise her to stop saying it, which bothered her because she felt it was the right thing to do." Fowler advised her to avoid being specific and simply wish patients "good luck" or state, "I hope your treatment is successful."

Make staff accountable

Barbara Novak, revenue cycle manager at Central DuPage Hospital in Winfield, IL, says, "Whenever possible, we encourage staff to 'own' a patient complaint.

Registrars are trained in how to respond to patient complaints, she says.  The key elements are apologizing, listening, and assuring the patient that his or her concerns are taken seriously and will be shared with the department leader, says Novak. "The staff member may send a communication to the supervisor or manager, who may follow up based on the issue and other factors," she says.

To get the actual facts behind the complaint, Novak talks with the patient or family member, the employees involved, and other departmental members. Recently, the following letter was sent to a patient who reported a less than satisfactory experience: "After consultation with our laboratory supervisor, we are working together to review the process surrounding registration timeliness and process flows for specimen drop-offs. We realize that your experience was time-consuming and less than our standard of Excellent service at Central DuPage Hospital."

All written complaints are entered electronically into a patient relations software system, which allows complaints to be tracked by departments and type, says Novak. "The leader over that department is often the one who calls the patient and writes the letter," she says.


For more information on managing complaints regarding patient access, contact:

Jan Fowler, Director of Patient Accounting, Saint Vincent Health Center, Erie, PA. Phone: (814) 452-5704. Fax: (814) 455-1724. E-mail: JFowler@svhs.org.

Barbara Novak, Revenue Cycle Manager, Central DuPage Hospital, Winfield, IL. Phone: (630) 933-6514. E-mail: Barbara_Novak@cdh.org.