Access faces unprecedented need for education and fewer resources

You'll need to use creativity, but don't skimp

Are you facing pressure to cut education resources in your patient access department? Reducing resources simply isn't an option, according to Wendy M. Roach, RDMS, manager of patient access and central scheduling at Advocate Good Shepherd Hospital in Barrington, IL.

"If you cut back on training, staff won't have the tools they need," she says. "You can be creative in finding less expensive ways to do things. But you can't skimp on the actual process." Roach uses these methods:

• Patient access processes are outlined on a single sheet of paper.

Anybody should be able to pick up the page, follow the step-by-step instructions, and succeed in completing the task, says Roach.

"It's a lot of work to do, but it's worth it," Roach says. "We also get the staff person's signature on the sheet of paper. They can't say, 'You never told me about this.'"

• An annual "boot camp" is held, with competency testing afterward.

Staff members receive two days of education on everything they might be tested on, and they complete a competency test afterward, with low scores resulting in retraining or disciplinary action. This year's testing revealed that staff were struggling with Advance Beneficiary Notices and coding, so more training was done in these areas, says Roach.

• Staff participate in a skills day.

The approach is similar to what is done in clinical areas, says Roach. She asks eight coordinators to present on various topics and create a display board. "We make it as eye-popping as possible, to keep their interest," she says. "It is set up like a job fair. The person who designed each board is there to talk about it."

The coordinators present on areas they're experts on. An order management specialist discussed coding, while Roach drew on her background in the hospitality industry to present on customer service.

Registrars now educators

More patient access education is being provided this year at TriHealth in Cincinnati, OH. but with no additional staffing, reports Stacey Bodenstein, general manager of admitting and registration. Bodenstein uses a combination of online learning, e-mails, one-on-one training, classroom training, job shadowing, and cross-training.

"Over the past several years, my staff has become more than just registrars gathering information," says Bodenstein. "Staff are now acting as educators for patients." For this reason, registrars need additional training to give them the ability to answer complex questions on benefits and patient rights and responsibilities, she adds.

Due to this change, employee titles of registrar I, II, III and lead were changed to access associates, access coordinators, access liaisons, and lead access coordinators. "These titles better suit their new role," explains Bodenstein. "They are not simply just gathering registration information. Staff are acting as access to our hospital system."

Online training is trend

If members of your registration team are working 24 hours a day, seven days a week, getting them to attend training sessions as a group might be next to impossible.

Candace Gray, MHSA, CMPE, CPEHR, director of admitting/registration at BayCare Health System in Clearwater, FL, struggles with this when coordinating the health system's annual full day of offsite training, held at the central business office. "Just trying to cover team members to be away for a full day is a challenge," says Gray. "Online training is less of a challenge. It doesn't require the night shift team members to switch their internal clock."

Having a registration pool/float team helps with coverage issues during training, she adds, and it helps reduce the need to pay overtime. "Our training team works hard to provide webinars. We have also tried to offer Saturday classes," says Gray.

Online training eliminates the problem of getting busy staff together as a group, says Susan Bauer, patient access/central scheduling educator at Edward Hospital in Naperville, IL. "Staffing limitations force us to deliver education through alternate sources when they are available," says Bauer, adding that online survey tools are used for pre-education assessments and post-education testing. Such surveys allow her to reach out to all employees, without having to physically gather for a meeting.

"This is more interesting to staff, compared to sending the same material by e-mail," adds Bauer. "It also connects the supervisors with their employees."

A recent online survey gave staff the opportunity to report confusion about complicated subjects such as Medicare secondary payer, for example, and the results were used to plan future training.

"It has helped to confirm that the staff are competent and doing well in the areas that we have assessed," says Bauer.


For more information on meeting the educational needs of patient access staff, contact:

• Tracy Abdalla, Hospital Access Services Supervisor, University of California — Davis Medical Center Hospital. Phone: (916) 734-3282. Fax: (916) 734-0550. E-mail:

• Susan Bauer, Patient Access/Central Scheduling Educator, Edward Hospital, Naperville, IL. Phone: (630) 527-5529. E-mail:

• Stacey Bodenstein, General Manager, Admitting & Registration, TriHealth, Cincinnati, OH. Phone: (513) 569-6212. Fax: (513) 569-6619 E-mail:

• Candace Gray, MHSA, CMPE, CPEHR, BayCare Health System, Clearwater, FL. Phone: (813) 852-3075. Fax: (813) 635-2652. E-mail:

• Wendy M. Roach, RDMS, Manager, Patient Access and Central Scheduling, Advocate Good Shepherd Hospital, Barrington, IL. Phone: (847) 842-4186. Fax: (847) 842-5325. E-mail: