Constant communication with patients waiting in registration areas has significantly improved satisfaction at Hackensack Meridian Health. Patient access employees tell patients:

  • if a prescription, authorization, or referral is missing;
  • if the physician order was not sent;
  • that a call was made to the doctor’s office or insurance company.

Waiting with no idea what’s going on “is the breaking point for many patients,” according Donna J. Roettger, CHAA, an access services trainer at Hackensack Meridian Health in Tinton Falls, NJ.

“Coming to the hospital is usually riddled with a lot of unknowns, and this can be overwhelming,” Roettger notes. Many patients don’t know what’s causing their symptoms, whether their problem is serious, or whether their insurance will cover the cost of services.

Although patient access can’t answer all the patient’s questions, they can keep patients fully informed during their wait time. “Waiting without being informed about what is going on can upset patients and cause unnecessary grief,” Roettger warns.

Explain All Holdups

Many different glitches can occur at check-in, delaying patients. “Staff may find out that the service requires an authorization. Or maybe the physician order was not sent, which can be a common struggle in patient access,” says Kim Rice, MHA, director of patient access at Shasta Regional Medical Center in Redding, CA.

Patient access staff work closely with the patient on each step in the process. “Often, things can be time consuming,” Rice says. “Staff provide ongoing updates to the patient while they wait in the lobby.” Patient access offer a meal ticket if the wait is unexpectedly long. “Usually, a gesture of kindness goes a long way,” Rice notes.

Patient access uses the same “constant communication” approach with clinical staff. “We make them aware there is a holdup keeping the patient in registration longer than anticipated,” Rice explains.

Keep in Touch

Just keeping in touch with patients can defuse simmering tension. “If a patient asks if they can have something to drink, we ask the nurse, then return to the patient with the answer,” Roettger says.

“How long am I going to wait?” is not always easy to answer. Missing prescriptions, authorizations, or referrals often cause the delay. “We often rely on other departments to perform exams or tests, or wait for doctor’s offices to send the required information,” Roettger explains.

When registrars are checking in a patient during a busy time, they’re careful not to specify how long the wait will be. Instead, they say, “We are presently experiencing a high volume, but we will get to you as soon as possible.” Instead of saying, “Someone will call you in a few minutes,” they say, “The tech will call you as soon as they are ready for you.”

In the ED, registrars say, “We’ve had a number of critical patients come in who need to be taken care of right away. I apologize for the wait, but someone will be with you as soon as possible.”

Like recordings used by companies to break up the hold time on phone calls, checking in with patients breaks up the wait. “Just peeking into a room with a friendly, ‘How are you doing? Can I get you a blanket?’ creates a connection,” Roettger says.

In the outpatient department, prescriptions often are missing a diagnosis, date, or doctor’s signature, or a patient may need a referral or authorization. This usually means registrars must call a doctor’s office or insurance company.

“The patient will sit and wait for the doctor or insurance company to get back to us,” Roettger explains. “If offices forget to send what they said they would, we have to call back and remind them.”

Patients don’t like to be kept guessing, so registrars make a point of telling them the call was made. “This not only resets that ‘wait-time clock,’ but the patients also feel like they have an ally,” Roettger says. “This distracts them from what often seems like an endless wait.”

Stress and anxiety go hand in hand with hospital visits and can’t be avoided. “But it can be alleviated — by registrars who are willing to take the extra step to keep patients in the loop,” Roettger says.


  • Kim Rice, MHA, Director, Patient Access, Shasta Regional Medical Center, Redding, CA. Phone: (530) 229-2944. Email: krice@primehealthcare.com.
  • Donna J. Roettger, CHAA, an Access Services Trainer, Hackensack Meridian Health, Tinton Falls, NJ. Phone: (732) 212-6039. Fax: (732) 361-9189. Email: Donna.roettger@hackensackmeridian.org.