Use 'visual audits' as coaching opportunities

"Customer service is something that is sometimes really hard to monitor," says Linda Smith, manager of patient registration and centralized scheduling at Barnes-Jewish St. Peters (MO) Hospital. "Unless you have direct interaction with staff, you don't always know. Typically, you can train someone for the necessary job skills, but that customer service piece has got to be there."

For this reason, Smith makes a point of doing frequent "visual audits" where she listens to staff talking with patients. "These audits are based on a requirement that we have committed to with our revenue cycle team. We ensure that our financial brochure is given to each patient. Staff make them aware of financial assistance they might be eligible for, using the correct scripting," says Smith.

Emergency department registrars also are audited to make sure they are asking for copays at the point of discharge.

"The audits are used as coaching opportunities. It also gives the employee some time to interact with his or her supervisor," says Smith. "Staff know they are being audited and understand why — so we can be sure we are delivering the information we are required to give. It is a good way to touch base with staff once a month."

Although "secret shoppers" aren't used, staff are encouraged to think of every patient encounter as a potential "secret shopper." "It may be an employee who works for the hospital, for example. And I guarantee if they do not receive good customer service, they will call me," says Smith. "They may be people who actually work here who know what the process should be, and they will give you feedback."

With this in mind, Smith tells her staff, "If you treat everyone with great customer service, and follow our process each and every time, there's really nothing to be concerned about."

Access staff are trained with the AIDET tool, standing for:

• acknowledge the patient;

• introduce yourself;

• duration;

• explanation;

• thank the patient.

"You don't want to sound as if you're saying the same thing over and over without any type of enthusiasm, but scripting can help staff to remember that the patient needs to be acknowledged," says Smith. The AIDET scripting would sound something like this: "Hi, my name is Linda and I'm going to be completing your registration today. This is going to take us about three or four minutes. Then you will go straight to the lab and they will take care of you. Thank you for choosing us for your service."

Smith says that although the patient access services are decentralized, her office is in the admitting department. Therefore, she can easily hear the tone of voice and comments made by employees. "Some of our long-term employees have that really strong knack for customer service. They make each patient feel that they are the only person they talk to today," she says. "A family member once surprised everyone by bringing a bouquet of flowers to a registrar to thank her for her service."

[For more information, contact:

  • Linda Smith, Patient Access, Barnes-Jewish St. Peters (MO) Hospital. Phone: (636) 916-9143. E-mail:]