When tension arises between clinical areas and patient access, poor communication usually is the culprit.

“Friction can occur with two different reporting lines,” says Brenda Pascarella, MS Ed, CHAM, associate director of patient access at Albany (NY) Medical Center. “Often, administrative staff are entrenched in clinical areas but report to a different manager.” For example, patient access staff work side by side with clinicians on bedside registrations in the ED.

“Open and ongoing communication is essential,” Pascarella says. Patient access meets regularly with clinical areas that they interact with frequently. “In our nonpatient lab stakeholder meetings, we discuss workflow changes that may impact our staffing,” Pascarella notes.

If patient access is informed of the time of specimen drop-offs or additional business coming in, staffing can be adjusted as needed. “Mutual respect for each other’s roles in the patient experience is essential,” Pascarella stresses.

If patient access builds a strong rapport with clinical directors, “they will trust your leadership,” says Kim Rice, MHA, director of patient access and communications at Shasta Regional Medical Center in Redding, CA.

Clinical leaders want to see that patient access takes care of issues immediately. Some examples include:

Delays in preoperative appointments. If patient access is running behind, wait times increase for preoperative or other clinical departments that are waiting for the patient.

“This scenario is not always avoidable, due to patients running late themselves,” Rice notes. Patient access contacts the clinical team to warn them of delays. “Giving them a heads up when we foresee a bottleneck in flow can usually keep the clinical staff from getting too upset,” Rice reports.

Concurrently, additional staff are pulled from other registration areas to unclog bottlenecks. “It gets the flow caught up, and keeps the clinical staff happy,” Rice adds. “They often don’t even know we were behind due to an increase in patient check-ins.”

Delays in admitting patients to the floor. “If we don’t admit the patient timely, the clinical staff can’t access the account,” Rice says.

It’s important that patient access staff members understand how their role affects other areas of the hospital. Otherwise, says Rice, “they will not know the trickle-down effect their work has on the clinical team.”

The incorrect status entered in the computer. For instance, an order may have been for an inpatient, but it was incorrectly entered as observation or same-day surgery. This is a red flag on which a registrar needs some additional training.

“Making the correct admission status to match the physician order is critical, as it determines room charges,” Rice says.