Niceness Counts: How Registrars De-Escalate Irate Patient Episodes
Registrars cannot always change what is upsetting someone. It may be a rescheduled appointment, an insurer who will not pay, or a long wait. However, many registrars have found that simply being nice is all that is needed.
“I want to convey to the person on the other end of the line that they are not alone, and I’ll work hard to change the outcome,” says Jenny Owens, BSBA, ASB, CHAA, a financial advocate at Wilmington, DE-based Nemours Children’s Health System. Here are some cases where registrars used empathy during difficult encounters:
• Scenario 1: A patient thinks an appointment was scheduled already, but finds out it really was not. This happened when home sleep studies were first implemented at York, PA-based WellSpan Health. The problem was that patients misunderstood the process. They were waiting to receive a device to use overnight and planned to return the following day to discuss the results. This was true, but it only happened after the patient calls to schedule a date for the device to be sent.
One woman complained that she was still waiting for the device to arrive. She was surprised to learn it was not an automated process. The woman did not react well to the news, and started reviewing every detail of what she had been told.
Instead of interrupting or becoming defensive, then-registrar Jill Augustyniak allowed the woman to talk. “I gave her time to tell her side of the story,” says Augustyniak, now a quality assurance specialist in the patient access department. Almost immediately, the irate woman calmed down. “I was able to defuse her negative emotions and regain her trust,” Augustyniak says.
Together, they went through the instructions, and the appointment was scheduled. Finally, Augustyniak gave feedback to a clinical care coordinator to ensure the process would be made clear to future patients.
• Scenario 2: A patient is upset for personal reasons and cannot be calmed. One patient with chronic illness started out a call by yelling for about 10 minutes. She did not understand why she had been receiving registration phone calls, or why registrars needed to know her name and date of birth. The woman was clearly overwhelmed about her health and her finances.
Instead of taking it personally, Augustyniak allowed the woman to vent, then said, “Let me help you work through this.” That is all it took to calm the angry patient. “She saw we were on the same side,” Augustyniak observes.
Later, the woman called a department supervisor to apologize for shouting. The woman recounted that she greatly appreciated the registrar listening. On that particular day, says Augustyniak, “everything in her life was building up. She just needed someone to talk to and a shoulder to lean on.”
• Scenario 3: A parent calls after receiving a bill after surgery, for which the insurance paid almost nothing. At Nemours Children’s Health System, this kind of situation arises more frequently these days. In one recent case, the mother’s insurance came from a part-time job, barely covering any of the hospital bill. Although the family clearly was underinsured, they did not quite qualify for Medicaid because of the father’s income. The balance after insurance totaled nearly $7,000. First, Owens reassured the distraught mom they would find a solution together. Monthly payments were offered, but the mother stated they were too high and could only pay $25 a month.
“The proposed amount was significantly lower than the payment plan estimator would allow,” Owens recalls. But it was clear the woman really needed help. “I used a tone of understanding and reassurance,” Owens says.
She could not do what the mom was requesting, so Owens connected her with someone who could. “Upon review, management agreed to allow the mother to pay the amount she stated she could afford,” Owens reports.
Registrars cannot always change what is upsetting someone. However, many have found that simply being nice is all that is needed.
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