More hospitals are allowing patients to make “reservations” to be seen in the ED at an estimated time. Registration processes are changing to reflect this new patient-centric approach.

When an online check-in process was implemented at Shelby Baptist Medical Center in Alabaster, AL, “initially, we had some bumps in the road to work through,” says Chief Strategy Officer Cristine Ferguson.

These mostly involved communication glitches regarding patients’ expected arrival times. “A few things were done to help improve the handoff processes,” Ferguson reports. “These were relatively simple changes, but proved effective.”

To eliminate confusion, the person who enters the patient into the system now initials the paper form before it’s handed off to the next person. Secondly, the paper form is filed in a designated place while waiting for the patient to arrive. Lastly, a field was added to the system so registrars can check a box indicating the patient checked in online.

“Once we worked out the kinks, the process is really no different than registering a patient in person,” Ferguson notes. Online check-in positively affected ED registration patient satisfaction immediately. “We have been able to collect many positive comments through this tool that we may not have otherwise received,” Ferguson explains.

Most patients carry unpleasant memories of sitting in a crowded ED waiting room for hours. They really appreciate waiting in the comfort of their home for non-emergent problems. “It puts the patient in control of his or her care,” Ferguson adds.

Everyone who uses online check-in with a valid email address receives a survey. Many patients compare it favorably against their previous ED visits. “We get lots of feedback suggesting that a person was using the tool for the first time, and how much better the experience was as a result,” Ferguson says. Most online check-in patients are seen within 10 minutes of arrival. “For the 2018 year to date, 94% of patients who used the online scheduling tool said they would recommend it to others,” Ferguson reports.

Online check-in also is used as a screening tool based on the patient’s stated symptoms. Sometimes, patients register online when they actually need to be seen without delay, such as those with possible symptoms of stroke or heart attack. “Based on the stated symptoms, the triage nurse makes the determination if the patient needs to be called to come in immediately,” Ferguson says.

Occasionally, patients who checked in online arrive at their appointed time, only to have to wait for care anyway. This usually happens because of a surge in unscheduled, high-acuity patients. “Luckily, most people are empathetic when we explain the unexpected emergency that has caused the delay,” Ferguson notes.