Some surges in volume are predictable, such as early morning check-in for surgery, necessitating long-term staffing changes. Other times, a large number of walk-in patients presents unexpectedly. Soon after, complaints start pouring in.

“At some point, the volumes overwhelm the number of registrars stationed at a specific site. It just backs everything up,” laments Maurice Winkfield, director of patient access at Lewes, DE-based Beebe Healthcare.

This problem was the No. 1 reason for complaints about patient access. The department instituted some changes to avoid understaffing during volume surges:

Leaders accumulated data on the number of complaints about wait times. They also kept track of the number of patients coming into the site for scheduled appointments vs. those arriving for unscheduled labs, ECGs, and X-rays. Volumes of walk-ins had clearly increased. “This allowed us to target specific days and times we needed additional staff to assist,” Winkfield explains.

More seating space was added. It turned out that eight seats were not enough in the main outpatient center, which handles registration for laboratory testing and all diagnostic imaging services. “Half of our total outpatient volume comes through that site,” Winkfield notes.

Some patients waited more than 30 minutes just to be registered. This was in addition to the time spent waiting for the service. “Two more seats were added by converting a break room into registration space,” Winkfield says. “We also added two additional registration stations.”

Several “flex” positions were created. “We can be flexible in having staff work in those additional spaces to limit wait times,” Winkfield offers.

Registrars take a moment to explain why registration takes as long as it does. “Patients don’t always understand the importance of the registration process,” Winkfield observes.

People were especially annoyed when asked for a photo ID even though they were just at the facility recently, or asked to confirm their address multiple times. Registrars shed light on why it is necessary to ask for or confirm such information. “We explain that we are doing this for their safety and to ensure that their insurance can be billed for the visit cleanly,” Winkfield says.

At Montefiore Nyack (NY) Hospital, inadequate staffing during high-volume times was well-known as a big dissatisfier. “Patients get an instant bad impression of the medical facility. Some will voice their dissatisfaction to hospital leaders,” says Patient Access Services Manager Jason Guardado. It is a safe bet that people will not hesitate to mention this on any patient satisfaction survey they might receive.

Close monitoring of patient volumes over time was the solution for the department. “It allows us to project the right staffing resources in the right areas at the right times,” Guardado says.

An outpatient area with high volume last month may not receive so many patients next month. “This allows the allocation of resources to be moved to other areas of need,” Guardado adds.