About 150 hours a year in overtime is no longer needed in the patient access department at Ochsner Health Systems, Westbank Region in Gretna, LA. This is because of a new “floater” position created several years ago.

The floater is able to cover all patient access roles, even the emergency department (ED). “We identify strong employees within the ED, who are already working weekends and rotating shifts,” says Sherry Whitefield, CHAM, director of patient access services.

ED registrars usually jump at the chance to become a floater. “The main reason is for the opportunity of being scheduled Monday to Friday during normal business hours,” says Whitefield.

Since the floater position was implemented three years ago, the percentage of patient access employees who say they are “actively engaged” has increased from about a third to about half of the department. The likely explanation: They’re no longer working short-staffed. This means personal days and vacation time are more likely to be approved. “Having the floater allows us to be able to approve personal time-off requests,” explains Whitefield.

All Areas Covered

The same training process is used for floaters as for other registration roles: The employee shadows the process and is trained by the supervisor. “After a few days, the supervisor then shadows the employee and reviews our competency checklist,” says Whitefield. The difference is that floaters do this for all areas — but only move to a new area after they’re fully comfortable with the processes and procedures of the first area. “At that time, the employee then moves on to the next area to begin the training, until the employee has completed all areas,” says Whitefield. After training is completed, the floater covers whichever area has the greatest need.

Patient access leaders work together to create the floater’s schedule. “The floater and her leaders know what areas she will be working a month in advance,” notes Whitefield. “Whatever department she is scheduled to work in, her time is coded to that cost center.”

The floater works 40 hours a week without incurring any overtime. “This has been a great success for patient access,” says Whitefield.

Floaters have left the position only for advancement opportunities, such as clinic scheduling, inpatient verification, and outpatient registration. “Employees find what they feel is their ‘fit,’ with opportunity for growth,” says Whitefield.

That includes leadership roles. Two of the floaters are now patient access supervisors. Another is a team lead in the department. “Being trained in several areas offers a wider knowledge range — and career advancement,” says Whitefield.


  • Sherry Whitefield, CHAM, Director, Patient Access Services, Ochsner Health Systems, Westbank Region, Gretna, LA. Phone: (504) 207-2638. Email: Swhitefield@ochsner.org.