Access staff may lack excellent service skills

Much more is expected upfront

When Michelle M. Mohrbach, CHAM, became manager of patient access and central scheduling at Blanchard Valley Health System in Findlay, OH, new hires typically "shadowed" another registrar for a short time before going out on their own. This approach has changed dramatically.

Now, new patient access hires receive 250 to 300 hours of department-specific training. "It is extremely valuable to invest in that. I'm of the belief that you get that back," says Mohrbach. "There is a lot more that we are expecting upfront now."

The training puts a heavy emphasis on service, regardless of whether the employee is working in inpatient admissions, point-of-service collections, or the ED discharge office, says Mohrbach.

"People have really started paying attention to service in the last few years," says Mohrbach. Part of the reason is that service is included in Hospital Consumer Assessment of Healthcare Providers survey scores.

The department relies strongly on the Acknowledge/Introduce/Duration/Explanation/Thank (AIDET) approach for customer service, though Mohrbach says that when it was first rolled out, it didn't come naturally to many of her staff.

"After they heard themselves saying it a number of times, staff began choosing their own words to convey it," she says. "It can give some staff who just don't have the words a way to start a conversation with the patient."

Scripting can help

The more patient access employees do, the more challenging providing excellent service becomes, says Mohrbach. "If you run medical necessity and you see that the diagnosis doesn't support the testing that was ordered, how do you put the patient sitting in front of you at ease?" she asks.

Scripting is used in this type of situation, to make patients aware of their out-of-pocket responsibility before testing occurs so there are no surprises when they receive a bill. "It's all in how you deliver the information," says Mohrbach.

Similarly, if missing orders or extended waiting occurs, staff use scripting to put a positive spin on the situation. "We don't blame the physician office for not faxing the orders," says Mohrbach. "Instead, we turn it around."

Registrars might state, "I'm sorry we don't have the order. This is very unusual for Dr. Jones. Let me call the office and get it faxed over for you," "Susie is working today and she's our very best phlebotomist. The short wait will be worth it," or "There was an emergency, and they are running a little behind. There are just two people ahead of you, so it should be just about five minutes. '"

Any negative comments are used as a learning tool for customer service training, such as a patient's recent complaint that no one was available when she came to the registration desk. When Mohrbach investigated, she learned that a certain employee had left the area for a moment to take an order to the lab.

"We told staff, 'This is what it looked like for a patient. Next time, ask someone to cover for you, even if it's only for a minute,'" she says. "Because the reality is, the minute you walk away, someone is going to come by."


For more information on customer service training in patient access areas, contact:

• Michelle M. Mohrbach, CHAM, Manager, Patient Access/Central Scheduling, Blanchard Valley Health System, Findlay, OH. Phone: (419) 429-7655. Fax: (419) 424-1864. E-mail: