At Goshen (IN) Health, metrics have given the patient access department a much broader perspective on how well it is performing.

“It provides a benchmark of our performance that is a national standard, and not just based on our own performance,” says Patient Access Director Sue Plank, LCSW, CHAM.

Using the National Association of Healthcare Access Management AccessKeys, Plank’s department has made great progress in two areas:

Average wait times have decreased from 11 minutes to two minutes. The department had been trying to address wait times for many years. It created its own metrics to measure improvement.

Before, registration wait times were measured manually at check-in. “We had software capabilities that we had never implemented,” Plank notes.

Finally, the department decided to use that software to track wait times electronically. Specifically, the software uses AccessKeys for daily reporting. Today, Plank’s department can collect the benchmarks to measure against, and the same is true for registrars. Employees can see their own registration times and their colleagues’ times.

“This inspired motivation for improvement, particularly in those of us with a little competitive spirit,” Plank reports.

When the COVID-19 pandemic began, Plank’s department made significant changes to the registration process. All outpatient registrations were moved to the main lobby. Walk-ins were asked to schedule appointments in advance. “Reduced volume allowed us to trial some new processes and technology,” Plank says.

By reducing walk-ins and increasing preregistered accounts, registration times decreased sharply. When elective procedures returned, all registrations still were handled in the main lobby. Registrations per week averaged 600 previously; now, that number is more than 800 — all while using the same registration full-time equivalent.

“But more dramatic was the number of patients who waited more than 10 minutes,” Plank says. Out of 600 patients in March, 212 waited more than 10 minutes. As of July, only 52 of 857 patients waited more than 10 minutes.

Patients are noticing. Some have commented on the short wait times. “We have many days where the number of patients waiting more than 10 minutes is in single digits,” Plank adds.

The department greatly improved registration accuracy. “Colleagues wanted to do good work, but didn’t have tools in place to measure their performance,” Plank observes.

The department created ways to honestly look at accuracy rates. “We didn’t defend or deny our mistakes,” Plank says.

The emphasis was on how inaccurate work created rework for other areas of the revenue cycle. “We began to realize that there was no registration standard across the health system,” Plank recalls. Each registration area was developing its own standard.

First, the department implemented software that would audit every account each time. Registrars can see their errors, and are held accountable for making corrections without waiting for someone to tell them a mistake was made. “This allowed us to determine whether errors were contained to individuals, or whether it was systemic,” Plank says.

Staff also look at their resolution rate. This tells them how many errors are going uncorrected. “Colleagues may make few errors. But if those errors go uncorrected, they can still have a significant impact on denial rates,” Plank adds.