At Children’s Healthcare of Atlanta at Egleston, patient access recently switched to bedside registration at the hospital’s 30-room day surgery department. Improving patient satisfaction was the biggest motivating factor for this change, says patient access manager Michelle H. Crumbley, CHAM.

Because they are a children’s facility, one or two parents come to surgery with the child. “Our waiting area seats approximately 50,” Crumbley says. This waiting area is also the waiting area for inpatient surgeries.

“During our busiest days, folding chairs are brought out, and we have families waiting out by the elevator,” she explains. With limited space, there wasn’t enough privacy during the registration process.

“Patients are now brought directly back to their assigned room,” says Crumbley. “Patient access comes to them.” This process is used:

  • Upon arrival, patients are greeted by a registration coordinator and are signed in.
  • The Day Surgery team provides a list of the day’s room assignments to the greeter.
  • A patient care assistant brings the patient back to a room. “Once in a room, they can now be more comfortable. The child can even lay down or watch TV,” says Crumbley.
  • Registrars use a wheeled computer to register the patient, collect out-of-pocket costs, and obtain signed consent forms.
  • An electronic status board lets physicians and nurses know the patient is in a room.

“Registration turns a light on above the door, once they are finished” to alert clinical staff that they can now come into the room to begin treatment, says Crumbley. “We’ve seen many benefits from this process,” she says. “We have brought together patient access and nursing.”

When registration was done in the waiting room, patient access and clinical staff had no contact with one another.

“But our impact on each other was huge,” says Crumbley. “We now share in a common goal, and our teamwork shows.”

Physicians now can see their patients between surgery cases, since the patient is already in a treatment room. “Before, patients might have been sitting out in the waiting area waiting for registration,” says Crumbley.

Family members are much less anxious and more comfortable being in a private room. “They are more willing to pay their copay in a private, relaxed environment,” she says. “And patient access staff feel more a part of the clinical team caring for the patient.”

Customer service scores, registration wait times, surgery first start times, and turnaround times are all being measured. Because the process started in January 2015, little data is available. “But even without these numbers, the success is evident by walking out into the waiting room,” says Crumbley. “There are no more folding chairs and no long waits.”

There is no increase in pre-op time for registration, she says. “Vitals and weight can be done prior to registration, and the nurse can go ahead and start her prep with the patient while registration is taking place,” Crumbley says.