Years ago in patient access, “a growth plan was rarely discussed with frontline team members,” says Cassandra Gardner, director of patient access services at North Colorado Medical Center in Greeley.

Patient access operates with a completely different mindset today. “We have a strong focus on encouraging and promoting emerging leaders from within,” Gardner reports.

The annual employee engagement survey revealed a problem. Patient access staff were finding opportunities to advance within the health system, but outside of the department. “To keep our stars, we needed to evolve,” Gardner admits.

Leaders looked at how other departments were improving retention, staff engagement, and morale. They created a career ladder based on those practices. The first version was specifically aimed at patient access representatives who had minimal experience with customer service.

“We added additional levels for staff to grow into, with more responsibility and experience required,” Gardner recalls.

One example is a new “lead” role, with the formal title of “senior representative.” The career ladder now covers senior representatives, associate managers, managers, senior managers, and directors. Gardner says several current leaders started out in entry-level jobs, and patient access is no longer seeing staff leave for other departments. “We are now seeing other departments lose team members to join the patient access teams,” she says.

At Phoenix-based Banner Health, many patient access employees have grown into leadership roles through the health system’s Aspirations, Results, Challenge to Grow program. “Employees are given development goals, designed to push them out of their comfort zone,” says Jarrod Brown, CHAM, senior director of patient access services.

Leaders check in regularly with participating employees to discuss progress. Recently, some employees were asked to be subject matter experts for a system implementation. “We checked with the project leader to solicit feedback on that individual’s participation level,” Brown says.

Patient access services also maintains an employee-led engagement team. “Employees are tasked with presenting various topics, such as an education item, progress on an action plan, or annual campaigns that Banner Health puts on,” Brown says.

The objective is twofold. It helps staff become comfortable with public speaking. It also conveys important messages to staff from their peers. “Sometimes, messages can resonate better coming from an individual on the same level as the audience,” Brown explains.

At Banner Thunderbird Medical Center in Glendale, AZ, some patient access staff are asked to attend an “emerging leadership” meeting. “In those meetings, we work on skills: How to set a smart goal, public speaking, putting together a PowerPoint presentation, effective communication, and conflict resolution, just to name a few,” says Chris Lugo, CHAM, patient access services admitting director.

Later, the emerging leaders train new hires, take additional online training courses, and help existing leaders with process improvement projects. “The employees are also cross-trained into other patient access areas [the ED, admitting, OB, and the infusion center],” Lugo says.

Monica James-Harper, patient access manager at Ochsner Healthcare System in New Orleans, says the key to reducing turnover is simple: “Staff need to know there is room for growth within the patient access department.”

The department promotes from within whenever possible. To do this, senior leads are given “stretch” assignments. One senior lead was asked to come up with a way to keep the department from creating duplicate accounts, and put a process in place to ensure two patient identifiers are used at every check-in. Another senior lead came up with the idea of making rounds in the lobby every 15 minutes to ensure every patient was checked in for their scheduled appointment.

The projects give the senior leads something to talk about when a leadership position does become available. “Many patient access team members have shared how impressed they are with the promotions that have taken place within the department,” James-Harper reports.