Tackle even the stickiest cross-departmental issues

Start spreading some goodwill

Often, problems that are a continual thorn in the side for patient access simply cannot be solved without the help of other departments. Likewise, you can spread no small amount of goodwill by helping others with their own troublesome "pain points." Here are some ways to improve cross-departmental relationships:

• Tell the other department what you need.

Getting some specific information can, at times, make the lives of access staff much easier. For instance, patient access staff at Seattle Children's Hospital were upset because they weren't getting the information they needed when floor supervisors called with an add-on for an admitted patient.

In order to schedule an admission, access staff needed six key elements: the patient's name, medical record number, date of birth, diagnosis, the name of the attending physician, and the service. A form was developed for admitting, but this was not shared with the floor supervisor group. "Once we did, both teams were on board. The process of add-on admits became almost painless," says Heidi Dunbar, manager of admitting/emergency department coordinator. "It was really very simple. As soon as the floor supervisor team knew what we needed to know and why, we started getting everything we needed."

• Attend meetings of other departments.

A liaison from Seattle Children's access department routinely attends staff meetings held by other key areas and vice versa. This keeps the lines of communication open. "I go to the charge nurse and attend staff meetings, and one of their representatives comes to us," says Dunbar. "This way, when issues come up, we already have a liaison we can go through."

• Find out firsthand what employees in other departments actually do.

If an access staff person is becoming frustrated with another area, why not have that individual go there to "shadow" the person and see what the job actually entails? "This has been very eye-opening, both for patient access and for other departments," says Dunbar.

In one instance, one member of Seattle Children's access staff spent a day with the insurance processing department. "They learned what takes place on the back end if insurances are coded incorrectly, and ultimately, what happens if the hospital does not get reimbursed in a timely manner," says Dunbar.

Access staff in the hospital's emergency department also shadowed the admitting access team for a day. "They discovered the downstream effects of incorrect patient information and documentation, and that the grass is not always greener on the other side," says Dunbar.

After shadowing another department, a previously frustrated access person typically returns with a new appreciation for the work done by that area. "They may come back saying, 'Do you know what they have to do every day?' That person is then a little more patient because they realize that everybody has a stressful job, not just them," says Dunbar. "They go sit in their chair for a day and see how they live and what they go through. Then, it's amazing how a complaint just goes away."

Connie Campbell, director of patient access of Mercy Medical Center in Oshkosh, WI, also uses the "shadowing" practice to defuse unnecessary tension between departments. "We have found success in sending staff to shadow surgery, radiology, billing, and the cancer center. Each time, we identify new ways we can do things for them," she says. "Staff state it always helps to know the other person's environment. It also puts a face to the registration name."

• Send out a short survey.

Campbell recommends sending a survey to other departments about an access service. Attach a letter explaining that your customers are important and you would like to know how well you are doing. "Besides the manager sending them, also have your staff send them. Have them return the surveys to one spot," says Campbell. "A simple e-mail with two or three questions works best." 

• Send a thank-you note.

"Teach your staff to always talk the other department up, stating how good they are. You'll notice it then comes back," says Campbell. "Our thank-yous are often surrounded with patient examples and the teamwork both units displayed."

[For more information, contact;

  • Connie Campbell, Director of Patient Access, Mercy Medical Center, 500 S. Oakwood Road Oshkosh, WI 54904. Phone: (920) 312-0002. E-mail: ccampbell@affinityhealth.org.
  • Heidi C. Dunbar, Admitting Manager/Emergency Department Coordinator, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98106-0371. Phone: (206) 987-3484. E-mail: Heidi.dunbar@seattlechildrens.org.]