Delays can be caused by slow registrars, the need for interpreters, too many patients scheduled at the same time, or talkative patients, among many other things, says Mindy Grubbs, patient access manager at Novant Health Kernersville (NC) Medical Center and Novant Health Clemmons (NC) Medical Center. Patient access leaders tackled all these issues and more to cut wait times. “Some save more time than others, but all are a factor,” Grubbs says.
• Managers added more registrars during the busiest times. “We also added team members when a new service was added,” Grubbs reports.
• Review the next day’s schedule for missing orders or Advance Beneficiary Notices (ABNs) that need to be corrected. “Getting this taken care of prior to the visit means there is no need to call physicians at the time of service,” Grubbs says. Registrars check that all the patients scheduled for the following day have an order attached. If not, registrars call the doctor’s office to request it. It is a big time-saver for patients.
“Requesting an order can take an hour or longer in some cases,” Grubbs notes. As for ABNs, registrars look for incorrect diagnosis codes the physician entered. “If we catch these the day before, we can request that the doctor correct the order,” Grubbs says.
• Save time when asking patients for ID and insurance cards. Registrars first look in the chart to see if it is in the system. If the registrar does need to ask for the ID and insurance card, the registrar proceeds with the registration while the patient is looking for it, which saves a minute or two.
• Added e-check notifications to the registrars’ screen. If the patient already checked in online, staff know the entire registration process does not need to be completed.
• Registrars no longer tell patients about next steps with their surgeries. “This is the same information that the nurse tells the patients,” Grubbs explains. “This can be eliminated, and is not the responsibility of patient access.” Registrars also were asking COVID-19 screening questions, even though patients had just been asked those same questions when entering the facility. “This step can be bypassed,” Grubbs says.
• Team members no longer ask patients to wait in their office if there is an issue that needs follow up. Some patients are add-ons and need an order from the physician’s office. If so, the registrar asks the patient to go to the waiting area. Securing the order “can take some time, and delaying the next patient is not the correct process,” Grubbs says.
• Registrars know what to do if there is unexpected down time. “Team members know how to handwrite armbands if the printer is down, or make copies of forms if the scanner is not working,” Grubbs reports.
• Registrars are discouraged from talking too much. “We explain to the team member that continuous conversation is keeping the patient from their appointment,” Grubbs says.
• Guest services escort patients to procedures instead of registrars. “We have a space that we ask patients to sit in so guest services know they are ready to be walked to the next area,” Grubbs says.
• Regardless of the wait time, registrars are up front about it. “If you know that the patient will have to wait an hour to be seen, let them know,” Grubbs says. “They may want to leave and come back.”