For years, ED registrars at Rockledge, FL-based Health First’s four acute care hospitals monitored the waiting room for patients arriving. Next, they conducted a “mini-reg” for each person.

“We realized we could improve our process to better serve our patients.” says Michelle King, manager of revenue operations and patient access services at Health First’s Cape Canaveral Hospital in Cocoa Beach.

The department decided to create a new registration role: the “office tech.” This allows registrars to focus on completing registrations and collecting from patients. The office tech’s responsibilities include: ensuring the proper patient is identified, creating a mini-reg account (using just the person’s name and date of birth), arm-banding the patient, and identifying the patient’s pharmacy of choice.

“We have become more effective and efficient since implementing this role,” King reports. “Our productivity has increased.” When interviewing candidates for the office tech position, King informs them they’re considered “gatekeepers” for the hospital. “They set the tone for a positive customer experience.”

Covering all ED shifts with an office tech remains a challenge. Currently, the office tech only covers the first and second shifts. Marked improvements in productivity were noted on those shifts almost immediately. Understandably, the department wanted to get the same results on the third shift.

“We had to get creative and work within our existing FTE budget,” King notes.

Support is offered as needed to the third shift by increasing the office tech’s eight-hour shift to 10 hours. This way, the third shift is staffed midway through. “This allows the sole night shift registrar to focus on completing registrations accurately and handling collections,” King says.

The office tech role is a good “stepping stone” into the registration department.

“This position provides them with the basics of registration,” King says. “It offers me a clear picture of their skill set and customer service ability.”

Another recent change fostered some friendly competition in the department. The prior week’s collections, productivity, and accuracy ratings are posted publicly so registrars can compare their performance against their peers.

“They have come to appreciate this information in order to keep themselves accountable,” King says.

Managers’ jobs are made easier because specific educational needs are pinpointed for each registrar. Mid-year and annual evaluations go smoother since there aren’t any surprises. “Registrars are already aware of their strengths and weaknesses,” King explains. Staff members receive a report card listing how they’re performing on all requirements. A month-by-month breakdown makes it easy to track improvements or trouble spots.

“This opens the door for a conversation about educational opportunities or successes that may result in promotions,” King says.

One area in which registrars struggle continually is collections. “Since this is such an important role for registration, we utilize our QA educational team for training,” King says. The trainers provide shadowing, scripting, and one-on-one role-playing to improve collection skills.

Quality and accuracy is another area of focus. “On a daily basis, we can see the types of mistakes they make,” King says. “Specific training improves their skills.”