Many patient access areas have been working short-staffed because so many registrars have to quarantine after COVID-19 exposure. Consequently, registrars are struggling with poor morale and unexpected overtime.

At Albany (NY) Medical Center, registrars took on an entirely new role: scheduling vaccines for the community, after the hospital was designated as a regional hub for COVID-19 vaccine distribution. “We needed to provide several staff for several weeks. Thankfully, the vaccine came in at a time when normal volumes were still low,” says Brenda Pascarella, CHAM, director of patient access.

The department provided schedulers for vaccine clinics without affecting normal operations too much. Concurrently, patient access staff were receiving the vaccine, causing additional staffing shortages. The department did not vaccinate all registrars at once to avoid potential short-staffing. “We did have several staff with side effects. The fact that we were able to stagger was helpful,” Pascarella says.

At Stillwater (OK) Medical Center, all patient access staff who were interested in taking the COVID-19 vaccine have now received both doses. “Our ER registration staff were included in Phase 1 with the clinical staff,” says Patient Access Director Renee Swank, CHAM.

The department paid patient access staff for the time spent seeking the vaccine. “Some were lucky enough to receive their shot in-house, but some had to travel to an offsite location,” Swank reports.

About 70% of the patient access department wanted the vaccine. The 30% who elected not to be vaccinated reported their doctor had recommended they not receive it because of a health concern. “Some younger staff were hesitant due to unknowns with fertility,” Swank notes.

Most staff reported no side effects, or only arm soreness. A small number had to miss one to three days of work after either the first or second doses because of elevated temperature, headache, or body aches. “Staffing has become much more manageable due to the high volume of staff who received vaccines,” Swank says.

For months, an unpredictable number of registrars were out quarantining at any given time. “Staffing gaps have been covered by our float registrars, who are trained to work in multiple areas. This has been a life-saver,” Swank says.

The department’s career ladder saved the day. One of the key requirements is to be cross-trained to work in an additional area of patient access. These flexible registrars receive a pay differential and agree to work any shift, any day of the week. “We try to plan their schedule a week in advance. But sometimes it changes due to staff illness or other unscheduled events,” Swank explains.

The float registrars work at any registration area at Stillwater Medical Center, as well as two smaller hospitals (Stillwater Medical-Perry and Stillwater Medical-Blackwell). “If we don’t have an open shift for them to cover, the floats assist with training new employees,” Swank notes.

Even with float registrars stepping in as needed, some registration areas remained short-staffed. Other areas managed with existing staff, but incurred an unusual amount of overtime. “Our department has typically been able to keep overtime at a minimum, but not for the past several months,” Swank says.

Overtime is stabilizing to typical minimal levels. At one point, though, schedulers and preservice staff were putting in five to 10 extra hours a week. “Burnout was a concern,” Swank says. “We did things like handwritten thank you notes, gift cards, and one-time cash bonuses to express our appreciation.”

Going forward, a vaccinated department and community will mean less upheaval with staffing. “As a leader, I am thankful that most of our staff are fully vaccinated,” Swank says.