Access wrongly blamed for clinical mistakes?

Confront the problem

Has your access staff been wrongly blamed for mistakes, delays, or other problems related to clinical areas? To avoid this problem, patient access must "link themselves with clinical departments and establish a relationship — a tight one," says Barbara Snodgrass, patient access manager at Legacy Mount Hood Medical Center in Gresham, OR. Snodgrass gives these recommendations:

• Meet clinical managers in person.

Snodgrass and her colleagues routinely attend staff meetings in clinical areas, which gives them the opportunity to offer feedback from the access perspective.

"You're meeting with people who you may have only talked to on the phone before," she says. "You've truly made progress when a director of surgery asks you to attend more meetings to get input on what you are seeing on the front end."

This sharing might be as simple as reporting that you're seeing registrations get bogged down at a certain time of day because patient volumes have increased, which then brings up the question of whether staffing needs have changed. "Access staff may lack understanding about what clinical areas do," says Snodgrass. "They are more effective on the front end with this knowledge."

She attends ED charge nurse meetings along with her supervisor and ED registration lead, as the ED medical director wants input from everyone who services the department. "If you leave somebody out, like patient transport, patient access, or housekeeping, something won't work," Snodgrass says. "If patient access is included, our patients win."

• Explain why access staff members' actions are helpful to clinical staff.

"Patient access staff tend to be very detailed people, while nursing teams want to focus on the individual," says Snodgrass. "There is sometimes a breakdown in understanding the importance of the money coming in."

Educate clinical areas that patients have a right to understand what their bill is going to be and that this understanding can result in better overall patient satisfaction in their area, Snodgrass recommends. "Otherwise, the patient is coming in worried about money because they are in the dark about what they're going to owe," she says. "If things don't go well upfront, the patient is going to come to them frustrated."

Likewise, if the patient encounters delays at registration related to clinical areas, the visit isn't likely to go well when the patient is seen finally. "You've already set the tone of the visit, and now you are trying to recover from it," says Snodgrass. "When your clinical partners realize that, there is more of a sense of collaboration."

Share your data with clinical areas.

Clinical managers might not realize that your patient access areas monitor wait times, for example, which is valuable information for them.

"They don't always understand that a lot of information we are gathering is helpful for long-term strategic planning," Snodgrass says. "Show them why specific data collection is helpful to a clinical outcome of a hospital."


• Barbara Snodgrass, Patient Access Manager, Legacy Mount Hood Medical Center, Gresham, OR. Phone: (503) 413-4367. Fax: (503) 413-2428. E-mail: