Some registrars at Ochsner Medical Center in New Orleans clearly were not happy in their jobs. Patient access leaders decided to survey staff to find out why. “We wanted to better gauge the career path in which team members wanted to venture upon,” says Ochsner Healthcare System Patient Access Manager Monica James-Harper.

All registrars completed an Aspiration Capability Engagement (ACE) survey with these questions: What are my career aspirations? What are my strengths? Where do I need to focus to grow? What motivates and energizes me?

Staff gave honest responses. One piece of feedback in particular stood out. “We learned that most individuals really don’t like to be patient-facing,” James-Harper says.

Many registrars admitted they really wanted to work behind the scenes. “For those staff, preservice or billing roles are a good fit,” James-Harper observes.

Registrars were encouraged to “shadow” colleagues in those areas to learn about the department and vice versa. “It allows team members to network and get their names out there,” James-Harper notes.

Sometimes, unhappy registrars find a better fit outside patient access. “In patient access, we only have a limited amount of positions to advance to,” says Brenda Sauer, RN, MA, CHAM, FHAM, director of patient access at NewYork-Presbyterian/Weill Cornell Medical Center.

Recently, the revenue cycle department needed trainers during a system implementation. Some registrars had been great preceptors for new patient access hires but wanted fresh opportunities. “They liked teaching people and liked explaining things, so I encouraged them to apply,” Sauer says. Four employees left patient access and moved into the trainer roles.

Other times, the problem is not the role itself, but the logistics. “Instead of losing a good employee who we invested in, we help them look for other opportunities,” Sauer says. Some registrars could not work nights, weekends, or holidays any longer, and wanted regular hours. Sauer encouraged them to apply for jobs at a newly created physician billing office. This approach prevents employees from leaving the hospital altogether, and helps other departments fill open positions.

Recently, patient access created an “ambassador” role after opening a new hospital. Sauer put the word out: The department was looking for people with top-notch customer service skills. “Six ambassadors were hired from within the organization,” Sauer reports.

Certain people have been perfect fits for patient access jobs, even though they have no relevant experience in the field. “When we are looking for new employees, we do look outside of healthcare,” Sauer explains.

Many recent hires came from the hospitality industry. In particular, hotel workers are a great fit for jobs requiring good customer service. “A person who works at the front desk of a hotel in New York City has to be able to greet people, think quickly, and provide a next level of service,” Sauer says.

At Rockledge, FL-based Health First, patient access staff can shadow other jobs. “If I have a registrar with a great work ethic who shows up on time every day, I don’t want to lose that person just because they can’t handle blood in the ER,” says Michelle Fox, DBA, MHA, CHAM, director of revenue operations and patient access. Other registrars became bored working in outpatient registration where the same thing happens every day, but thrived in the unpredictable ED. Staff in preregistration might find they really hate talking on the phone all day and want a patient-facing role; others have a knack for the complexities of insurance and want to switch to the authorization team. Luckily, there is no shortage of roles in patient access. “We’ve had people go back and forth, from front end to back end,” Fox says.

Registrars can shadow a shift for a morning or a full day. “Sometimes, they end up loving the job; other times, they realize it’s not for them after all,” Fox explains.

The perfect match is not always in patient access. One registrar brought a family member to the hospital and thought the radiology technician’s job looked appealing. “We’ll facilitate that as well,” Fox adds. “We’ll do whatever we can to find the right fit.”


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