Delays? Be clear who is responsible

If an admitted patient is impatiently waiting for a bed to become available, and all he or she sees is access staff, it's easy to come to the wrong conclusion about who is really responsible for the delay.

"When we are the ones talking to them, there is a sense that patient access 'owns' those beds," says Barbara Snodgrass, patient access manager at Legacy Mount Hood Medical Center in Gresham, OR.

In this situation, Snodgrass says to be clear about what the obstacles are and what is being done about them, instead of simply saying, "We're working on it." Instead, she recommends telling the patient, "Our nursing supervisor is aware of this issue and is working on this for you. I will report back to you in 10 minutes."

"Now, the patient has something he or she can understand," says Snodgrass. "Don't assume a patient realizes all of the complications involved with getting a room. They may think that you just find a room and send them up there."

Likewise, an emergency department (ED) patient might believe wrongly that members of the registration staff are the ones responsible for his or her long wait. "Patients don't understand that the ED is not a clinic, where you see a person arrive after you and you go in before them," she says. "That's something that gets people really irate."

ED registration staff might need to inform patients that the front end staff members aren't responsible for the order patients are seen, says Snodgrass. Problems occur when patients receive mixed messages, she says. "If a triage nurse comes out and blames access, that is a sending a very bad message to the patient," Snodgrass says.