A patient access council was created at Children’s Mercy Kansas City in response to staff demand for more challenging work and recognition.

  • Representatives from all locations are included.
  • Participants have a chance to use expertise such as writing and fine arts.
  • Patient access supervisors are available as resources for the group.

When patient access employees recently responded to their organization’s annual anonymous survey, which seeks feedback on leadership, transparency, and satisfaction, they offered three typical responses:

  • “If I contribute to the organization’s success, I do not know that I will be recognized.”
  • “I do not find my job interesting and challenging.”
  • “When the organization makes changes, I do not understand why.”

“Although patient access scores highly in most areas, I decided to focus on our four largest areas for improvement to start,” says Savannah Lacy, preregistration representative, patient access, Children’s Mercy Kansas City (MO). These were:

  • staff recognition;
  • a desire for challenging work;
  • more transparency;
  • a greater understanding of the decision-making process.

“Patient access is our second-largest department in the hospital, next to nursing,” Lacy notes.

Lacy interviewed a couple of nurses and nurse managers to find out how they created unity within their teams and improved employee satisfaction. She learned of the department’s nursing unit council.

“The nursing council is a group you must apply to be in, which is led by more seasoned nurses, much like a student council,” Lacy notes.

She really liked the idea of creating a patient access council similar to nursing’s. She wanted to include staff members from all five locations.

“We wanted something that would be run by a group of peers within our department,” she adds.

Patient access leaders decided to create a council of 15 staff members in non-leadership roles as representatives for the department of 240 employees. Names were drawn at random from the 50 employees who volunteered to participate.

“We designated a small group of working supervisors as their resources and leads for the first year,” Lacy says. During its first meeting in fall 2015, the patient access council:

  • made introductions. Participants explained at which campus they worked, how long they’d been at the organization, and why they wanted to be on the council.
  • decorated small signs with their names, to reflect something interesting about themselves. “For instance, mine had a tent and trees because I like to camp,” Lacy says. “This helped us remember each other’s names.”
  • played a “get to know you” game. Each person took five candies, and answered a different question based on the color of the candy, such as, “What would you do if you won a million dollars?”
  • assigned homework. Employees were asked to create their own personal mission statement. At the next meeting, everyone worked together to create a mission statement for the group: “Our mission is to be an advocate for admissions staff by providing a safe environment to share ideas in order to encourage a culture of transparency and unity while promoting continued growth. We will encourage a culture focused on service excellence, while keeping a lighthearted and creative atmosphere, through positive communication with one another and leadership.”

The department is experiencing a variety of benefits — some unexpected — as a result of the council’s work.

  • Participants have the chance to put skills unrelated to patient access to use.

“Utilizing these skills in creative ways, they feel more fulfilled in their current roles,” Lacy says. “This has really improved our employee satisfaction.” Employees with fine arts and graphic design skills designed T-shirts and jackets for the council, while others wrote articles for the department’s newsletter.

  • Participants started a tradition of volunteering at the hospital’s Ronald McDonald House.

“We are looking into other philanthropic opportunities in the community,” Lacy adds.

  • Different teams within patient access have learned a lot from one another.

The department includes financial counselors, insurance analysts, educators, bed control and admissions specialists, and patient access representatives.

“Although these sections of the department work alongside each other, they don’t often work directly with one another,” Lacy explains.

The council gave them an opportunity to do so, and in the process, they saw how their roles fit into the department overall.

“It gives them an avenue to meet new people and a larger sense of a team atmosphere within our department,” Lacy adds.

By understanding how their work affects the overall revenue cycle, staff members are more likely to take their time when entering data. Thus, they are more likely to avoid errors, thereby improving registration accuracy.

“This is cutting down on the number of mistakes staff members are making, such as not gathering the correct insurance information or the Social Security numbers of guarantors,” Lacy notes.

The council helped patient access educators develop refresher courses on out-of-network insurance options and interpret legal documents, such as power of attorney or custody documentation.

“These courses have cut down on errors, such as an incorrect family member signing a consent form, or a family not being alerted of their out-of-network insurance coverage,” Lacy says.


  • Savannah Lacy, Pre-Registration Representative, Patient Access, Children’s Mercy Kansas City (MO). Phone: (816) 302-6914, ext. 76914. Email: snlacy@cmh.edu.