Inadequate staffing during high-volume periods is a top dissatisfier in registration area surveys. Experts offer potential solutions to minimize this frustrating occurrence.

Preregister more patients. “We have found that if we have the majority of our patients preregistered, it takes fewer registrars to handle the load,” says Rebecka Sandy, CHAA, CHAM, team lead of outpatient registration, preregistration, and financial counseling at CoxHealth in Hollister, MO.

Clinical areas promote preregistering to their patients, which has improved patient flow dramatically. “Even nonscheduled patients, such as our lab and X-ray patients, can preregister,” Sandy reports. “We can verify benefits, make sure we have the order, run medical necessity, and have financial discussions, all prior to service.”

Preregistration staff are cross-trained, which allows them to cover all registration areas. “I have also ‘mirrored’ schedules,” Sandy says. “I always have at least one preregistrar and one registrar for each shift.”

Schedule based on data. Registration areas at Loma Linda (CA) University Medical Center are staffed based on historical volumes and arrival times dating back to 2007. Of course, not all departments have access to a decade of data. But if that is the case, Admitting Director Denise Rotolo suggests collecting it for at least three months: “Then, adjust schedules to accommodate,” she offers.

Must-have data include patient arrival time, registration wait time, and registration transaction time. “These are crucial to successful scheduling,” Rotolo stresses. Registration areas re-evaluate these data while recapping the previous month’s metrics. “We have used these statistics to implement schedule changes on many occasions,” Rotolo reports.

Significant volume increases over a period call for a more comprehensive response. The department conducts a staffing analysis to see if additional full-time employees are warranted.

To keep delays to a minimum, patients who are in complicated situations are handed off to a supervisor or manager. This way, registrars can move to the next patient quickly. “This allows us to keep the normally scheduled, authorized patients moving through the process,” Rotolo notes. If registrars are late checking in a patient, that patient might miss his or her appointment, which no one is happy about. “We have wasted valuable clinical resources that result in multiple levels of lost revenue,” Rotolo adds.

All patients are preregistered at the time of scheduling. “This allows our check-in staff to confirm demographics without having to do timely data entry,” Rotolo says. The only areas with new patients entering the system are the ED and the walk-in lab draw station.

“These data are captured in our Epic statistics based on the first encounter in our health system or a return patient to our health system,” Rotolo says.