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Workplace environments in patient access can convince some employees to stay or even to return to the department after leaving.
When an experienced registrar gave notice to her supervisor, Mike Potter, he learned it was only because of money.
“The registrar went to a competitor for a $2-an-hour raise. I went to the HR department, but we couldn’t compete with that,” says Potter, patient access service director at CHI St. Luke’s Health – Lakeside and Springwoods Village Hospitals, both in Houston. The registrar took the job offer, after being told she was being compensated fairly in comparison to colleagues.
A few months later, however, Potter got a phone call from the employee. “She said, ‘Can I come back? The extra money isn’t worth it,’” he says.
The employee missed the department’s supportive culture, which was something she had not found in her new job. “There, the emphasis was on productivity. She felt she was looked at as just an employee and not a part of something bigger,” says Potter.
Potter says being a “family first” leader helps him to retain his best registrars. “Patient access employees can go to any hospital in any city and get the same thing,” he says. “We can’t always be competitive with other markets.”
What makes the difference, he says, is whether employees look forward to coming to work every day. “I like to tell them, ‘You don’t work for me. You work with me,’” says Potter. (See related story later in this issue on meetings between patient access employees and the hospital’s CEO.)
“I’m leaving, unless I get a raise” is something all patient access managers have heard at one time or another. Potter says he has had some low performers and mid-performers try that approach on him.
He tells those employees that during their next performance review, he’ll evaluate whether they qualify for a merit-based increase. If it’s a high performer who is asking for a raise, the compensation department reviews the request. “I don’t want to lose them to the employer up the street,” says Potter. “But if they’re asking for the stars, I can’t compete with that.”
Nancy Diamantopoulos, director of patient access at Holy Family Hospital – Methuen (MA) and Holy Family Hospital – Haverhill (MA), always lets employees know that she doesn’t want to lose them. “I always ask why they’re leaving,” she says. “Just having that conversation can sometimes turn things around.”
Recently, a registrar at CHI St. Luke’s Health began looking for another job only because her work schedule made it impossible to be at the school bus stop each afternoon to meet her children. When Potter learned about this problem, he asked the registrar to give him the opportunity to fix the problem. He then found another employee who agreed to switch shifts. “That registrar probably would have left because of a 30-minute difference in their shift,” he says.
An open, friendly demeanor makes it far more likely that patient access leaders will be privy to such information. “If they feel they have to whisper when they see you coming, you won’t learn the feedback they have to give you, good or bad,” says Potter.
Recently, Potter needed registrars to work an extra shift. A registrar came forward with an unexpected request: “If we have to work on a Saturday, can we wear jeans?”
Potter agreed, and the registrars worked the shift. This one-time change doesn’t mean the department’s dress code can be disregarded routinely. “But if you’re doing something extra for me, I can do something extra for you,” he says.
Potter prides himself on “growing” his employees. “As a manager, you have to be personally invested in employees. That means you’ve sometimes got to let them go,” he says.
When the hospital was part of a five-hospital system in the Houston area, Potter often put in a good word for bright employees if a supervisor position opened up at another location. The hospital’s recent merger with Catholic Health Initiatives opened up many more potential positions.
“I now have the potential to grow employees across the nation,” Potter says. “It’s not just registration. There are so many different areas of the revenue cycle that these employees can be opened up to.”
If employees are leaving to advance their careers, Diamantopoulos doesn’t try to convince them to stay. Instead, she takes it as a compliment.
“It’s a testament to the confidence they have attained through my leadership,” she says. “It’s hard to let excellent employees go. But I am always happy for them.”