Executive Summary

Patient access employees appreciate being asked to participate in projects, and the department benefits from their feedback. Below are examples of employee-led projects at Kadlec Regional Medical Center.

  • Create inventory lists.
  • Find ways to decrease the number of cancelled appointments.
  • Determine collection goals for individual registrars.
  • Identify what takes registrars away from their standard workflow.

Are you brainstorming for ideas to improve your patient access department? Look no further than your best registrars.

“We encourage our employees to participate in projects and committees focused on process improvement and patient experience,” says Jackie Jordan, MBA, CHAM, patient access and scheduling manager at Kadlec Regional Medical Center in Richland, WA.

This allows the employee and the department to reach important goals.

“It provides the team with front-line employee knowledge, and helps the employee build their skills through project work,” says Jordan. “Together, it’s a win-win.”

Andrew Moreno, CHAA, a patient access lead at Kadlec Regional, has worked on many departmental projects. “It is very important to let employees know that their opinions and efforts matter to the department,” he says. “Employees may have a better solution!”

The first project Moreno worked on was a simple yet important one — creating a department inventory list. “Using the list, I can determine what supplies are needed, and when to order more supplies,” he says.

Subsequent projects centered around cost-reduction. “I figured out that it would be cheaper to make copies of necessary documents in our department rather than ordering them through the print shop,” he says. However, Moreno later learned that it wasn’t quite that simple. The quality of the copied documents wasn’t good enough. Also, the department’s copy machines were overloaded.

“Another reason why this method wasn’t implemented is the amount of changes that can happen to the documents. Ordering through the print shop ensures the most up-to-date documents,” explains Moreno.

However, another of Moreno’s waste-reducing ideas was a keeper. It involved documents prepared by patient access. These used to be done for all of the following day’s appointments — some of which ended up being cancelled.

The department now prepares documents only for early-morning appointments. At that time of day, staffing is minimal, so pre-prepared documents are a great help. “This helps with check-in times,” says Moreno.

Improved Workflow

Moreno recently participated on a Patient Access Task Force, which included team members from the ED, the authorization unit, central scheduling, the outpatient imaging center, and the main hospital’s registration area.

“Together, we found ways to improve workflow and reach some of our goals,” says Moreno. Annual point-of-service collection goals were one area of focus, but the target amounts seemed unrealistic to some employees. “Instead of seeing a figure in the millions, I was able to break it down on a per-person basis to a figure in the hundreds per day,” Moreno says.

The task force also tackled the costly problem of failing to obtain required authorizations from payers. An authorization requirement was added to the scheduling questionnaire to make sure the authorization is obtained prior to scheduling.

Next, the group identified common occurrences that took registrars away from their normal workflow. Doctors’ offices sending patients over without complete orders fell into this category.

“By communicating with the appropriate department or caregivers on ways to improve, we were able to see a decrease in these trends,” reports Moreno.

Moreno credits his own high morale to the employee-led projects: “Having expectations that go above the routine job description brings a high level of self-worth.”

Regulary meetings with Jordan are an important part of the process, says Moreno: “I can learn the skills needed from her experiences while building mine in the process.”


  • Jackie Jordan, MBA, CHAM, Patient Access/Scheduling Manager, Kadlec Regional Medical Center, Richland, WA. Phone: (509) 942-2797. Email: Jackie.Jordan@kadlecmed.org.
  • Andrew Moreno, CHAA, Patient Access Lead, Kadlec Regional Medical Center, Richland, WA. Phone: (509) 942-2635. Email: andrew.moreno@kadlec.org.