The amount of needed education for patient access is only increasing. “With constant changes in both work and regulatory environments, there is a need for consistent training for both new hire and current employees,” says Drew D. Totten, principal administrative analyst for patient access services at Los Angeles-based Ronald Reagan Medical Center.
To keep up, multiple education approaches are needed. Totten’s department uses three approaches:
• Online training. This does not work for some subject matter. “But there are several topics that can be delivered effectively online,” Totten says.
Staff use online modules on new hire work rules, radiation safety, patient privacy regulations, sexual harassment, and cybersecurity. Distraction is the biggest downside when training is conducted online. “Interruptions disrupt the flow of the training and may impede the employees’ ability to understand the material,” Totten observes.
On the positive side, online modules help with productivity. “It frees up time for the managers so they can focus on the day-to-day operations,” Totten adds.
• Classroom training. Complex patient access topics are not well-suited for the online model. Such issues are covered in the traditional classroom setting instead. “These are very intricate and detailed, requiring the employee’s complete attention,” Totten explains.
Financial counseling, insurance verification, and collections are good examples. “Patient access trainers can assess employees’ understanding in real time, and make changes to how they’re presenting the information,” Totten reports.
• A “Train-Do” model. This approach has been extremely successful, according to Totten: “Our best practice is to have the employee complete a training course, then immediately apply the newly learned skills,” he says.
With this “Train-Do” model, people become truly proficient. “Each employee is trained identically,” Totten says. “The skills are applied while the information is still fresh.”
For complex tasks, managers monitor the employee’s work closely. This includes admitting a patient from the ED. Depending on the reason for the admission and the insurance, there could be dozens of steps in the registration process. It starts with greeting the patient; it ends with their admission into the hospital. “We want to ensure each employee follows each step accurately,” Totten stresses.
Confirming or obtaining details on demographics, insurance, financial liability, and all kinds of documentation are involved. To be sure it is all handled correctly, managers periodically review five ED admission cases at random. “This reduces workflow errors, saves time on retraining, and decreases claim denials,” Totten says.
The patient access department at Cambridge Health Alliance in Malden, MA, uses online training for the following:
- Introducing new hires to the revenue cycle;
- Using the department’s real-time eligibility verification system;
- Completing unique registrations, such as people who want to remain confidential or those involved in motor vehicle and industrial accidents.
“Now that we are on one system, we are beginning to get reports on denials or registration errors,” says Maryann Heuston, senior director of revenue cycle access operations.
Leaders can trace a denial to see whether it began at the point of scheduling or registration. “We can ask ourselves questions like, ‘What is causing $500,000 worth of denials? And how can we tackle it with training?’” Heuston reports.
If an employee is prone to a particular mistake, he or she is asked to sign up for an online course. This allows for quick, targeted training, as many times as needed, for that employee to become proficient. “That is very useful because you don’t have to pull someone into a classroom,” Heuston observes. “They sign up for the course, and don’t have to leave work.”
The department is now looking for a resource for creating some additional online training. Currently, it is handled by a trainer on the clinical side. “We talked about possibly outsourcing the creation of these courses. But we want to keep control of managing and updating them,” Heuston says.
The Cambridge system includes three hospitals and 30 ambulatory clinics spread out over three cities. “You have to get a significant amount of information to a varied audience,” Heuston notes.
Online training helps with the sheer amount of information that needs to go out to about 400 front-end registrars. “It’s a way to get information down to the front-end user without having to take them out of their work location to a centralized training center,” Heuston explains.