Designate 'go to' person for registrars, clinicians

Stop communication breakdowns

In a quick-moving, high-volume area such as the emergency department (ED) of Botsford Hospital in Farmington Hills, MI, communication breakdowns are bound to happen between patient access and clinical staff. 

"A common issue is clinical staff not knowing if or when patient access staff has come to register a new ambulance arrival," says Adam Boyer, the hospital's information services coordinator for patient services, who helps oversee the ED registration team.

Extra visits or potentially duplicate medical records might be created for new ambulance arrivals if the same patient is accidentally registered twice, explains Boyer. "The patient access staff may also feel their hard work is going unnoticed if they are being asked to register a patient who they already registered," he says.

At times, the clinical staff discharges a patient before access staff has been able to complete the registration. "When patients are discharged before being registered, this can cause headaches for patient access, as well as the clinical staff," says Boyer.

In this case, patient access is missing out on the chance to obtain accurate insurance, demographic, and address information, as well as an opportunity to identify and collect a co-pay, he explains. "If the clinical staff needs to make a follow-up phone call, they may have no way of getting in touch with the patient, due to the missing information," adds Boyer.

Shift leads created

To improve the communication between the registration team in the ED and the clinical staff at Botsford Hospital, shift leads were created.

"The shift lead is the 'go to' person for the clinical staff to come to, if there are any potential problems," explains Boyer.

Each shift lead carries a portable phone, and the name and number for the shift lead is made available to the clinical staff.  The shift leads and clinical managers meet monthly to discuss ongoing issues and process improvements in the ED, says Boyer.

Members of the registration staff feel a greater sense of appreciation, and clinical staff knows they always have someone who can resolve any potential issues, says Boyer. "Best of all, with the constant interaction at the monthly meetings, any problems between the two staffs are no longer allowed to fester," says Boyer. "The group works more like a team, rather than separate units."


For more information on communication with clinical areas, contact:

Adam Boyer, Information Services Coordinator, Patient Services, Botsford Hospital, Farmington Hills, MI. E-mail: