The Virtues of Real-time Registrar Observation
Patient access leaders can learn a lot from annual evaluations or soliciting feedback at staff meetings. But, sometimes, they learn even more from observing an employee during a shift.
Thirty minutes each day, usually between 9 a.m. and 9:30 a.m., are blocked off for rounding at UCHealth Yampa Valley Medical Center. “It’s important to get out to your team so they know you are accessible,” says Ryan Larson, director of business development.
Employees are much more likely to contact higher-ups who they see regularly in the department. “It gives us a different perspective on how the employee feels about the work, and the challenges they may have,” Larson says.
Recently, ED registrars confided that they were embarrassed at how shabby and outdated the department looked. This led leaders to put in an immediate request for new chairs and carpeting. Leaders are on the lookout for signs that staff are struggling with new processes. Leaders ask open-ended questions (“Do you have any concerns?”) to gauge problems. Through closer engagement, patient access leaders learned new information:
• Employees were not explaining the new process for patient identification properly. Staff were uncomfortable with the new process, which involved taking pictures of patients. “They felt it was intrusive,” Larson explains.
Managers took the opportunity to make an important point: The photos were about patient safety. “Patient identifiers are huge for patient safety. This is one of the fail-safe ways to ensure you have the right patient,” Larson says.
Managers offered helpful tips on how to explain the change to patients. Later, an inservice was provided to all employees, since many others also were struggling.
• Some registrars were struggling to collect because they did not have good information on the patient’s out-of-pocket costs. Another registrar reported difficulty identifying the patient’s insurance if there was a secondary plan. Additional training was provided for both scenarios, which focused on how to correctly interpret the patient’s benefits.
“We also set goals for point-of-service collection,” Larson adds. “We helped staff understand the ‘why.’”
For Jackie Jordan, MBA, CHAM, visibility in registration areas is the best way to show employees they are valued. “If we consistently add rounding to our leader ‘To Do’ list, it builds engagement,” says Jordan, manager of patient access/central scheduling at Kadlec Regional Medical Center in Richland, WA. This gives leaders an opportunity to identify problems, large and small.
“We take the information we receive and ask ourselves, ‘What did we learn?’ and ‘What issues do we need to resolve?’” Jordan says. During rounding, Jordan says her employees reported a few problems:
- Internet issues were causing registration delays. “It ended up being a broken access point. IT fixed it when I told them of the problem,” Jordan reports.
- The greeter was highly stressed due to outpatient services scheduled on the same day each week. “Administration was able to move certain services to a different day, and provided relief to the greeter for half a day to reduce burnout,” Jordan says.
- Broken equipment. Employees reported faulty headsets, missing staplers, and jamming printers, all of which were quickly replaced or fixed.
“When we ask the right people the right questions, and follow up, satisfaction will follow,” Jordan offers.
The opposite happens if leaders ask several questions during rounding, but never close the loop.
“Employees will likely lose trust,” Jordan warns. “They will be less likely to let you know there is an issue in the future.”
Patient access leaders can learn a lot from annual evaluations or soliciting feedback at staff meetings. But, sometimes, they learn even more from observing an employee during a shift.
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