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Want your worst problems fixed? Ask staff
Whether your biggest "pain point" is a sudden surge in denied claims, terrible compliance with a new payer requirement, or a slowly growing trend of unhappy patients, the solution comes from the same place. Your staff know the answers whether they realize it or not.
Start by asking staff for some feedback to improve processes during staff meetings. "This engagement allows everyone to have buy-in and make suggestions based on their experiences during patient interactions," says Nancy Jamie, director of patient access at East Orange (NJ) General Hospital. "This input and level of involvement allows managers to identify any drawbacks prior to implementing or revising a process."
It also makes staff feel more involved with the decision-making process. "After we have covered all the agenda items during our monthly meetings, I take the remainder of the meeting for open discussion," says Jamie. During this time, staff are encouraged to speak about anything that is relevant to the department.
One topic of discussion involved patients who were seen by a primary care physician coming back because they misplaced their referrals. "One of our front-end staff recognized that patients were returning for multiple copies of their referrals," says Lynette Massey, manager of the family health center. "The staff member then spoke with me, and it was brought up at our staff meeting."
The group discussed some ways to efficiently improve this process. Ultimately, a binder of patient referral copies was created, which could be maintained for six months. "With this process, patients can obtain a copy of their referrals from the patient access department," says Jamie. "This has served multiple purposes."
Patients say that having this information easily accessible has prevented them from having to reschedule appointments with specialists. For the clinical staff, the process saves the time required to retrieve a patient's medical records and make multiple copies.
"This has proven to be successful, and a time-saver for everyone," says Massey. "We also spoke with our clinical team to make them aware of the new procedures. We asked that they assist with educating our patients."
The patient access department at Albany (NY) Medical Center started a new rounding initiative in order to connect with staff more closely. The leadership team asks these questions: "What is working well?" "Are there any team members that I should recognize?" "Do you have the tools and equipment you need to do your job?" "Is there anything that we, the leadership team, could do better?" "What else would you like me to know?"
"The greatest takeaway is additional recognition of staff," says Catherine M. Pallozzi, CHAM, CCS, director of patient access. "The manager cannot be everywhere all the time. This provides the opportunity for the manager to recognize staff that they have been told about."
These questions are not meant to replace the informal contact managers already have with staff, such as making personal inquiries about their family, children, or a special event.
"It is done in addition to this. The questions are pointed to the workplace," says Pallozzi. "It provides another opportunity for the manager to reach the staff member at a slightly different level. It opens up a different opportunity for the manager and staff member to form a better relationship."
A yearly survey of patient access staff is conducted each October. "This has proved to be an invaluable tool. We have had much success, with a 79% to 82% return rate, and for surveys that is wonderful," says Pallozzi.
The unit results are reviewed with the manager to discuss any issues that need to be redirected. The overall survey results are reviewed at the December quarterly staff meeting. The managers are expected to review the unit-level survey response at the monthly unit meeting.
"Certainly, the survey has identified some of the day-to-day needs that were easily rectified," says Pallozzi. "Once you commit to a survey, you need to be open-minded to whatever information is provided to you." Here are some changes the department made:
Automatic doors were obtained for registration, as patients were having great difficulty opening the doors.
Specific training sessions, which staff wanted to attend, were provided.
The monthly newsletter was reformatted and shortened to encourage all staff to read it.
Valet parking hours were increased in the emergency department.
Staff were provided coverage for all breaks and lunches.
Hours were increased in a particular unit. "A staff member thought it was worthy of consideration, and it was," says Pallozzi. "These are all small things, with the exception of the doors, but we eventually got them. I always say it is not the big things that matter to staff as much as the small day to day."
However, Pallozzi says that the most significant change came about when staff provided constructive feedback about their manager.
"Issues such as communication and visibility were brought forward. The staff truly provided insight on what they wanted from their manager," says Pallozzi. "The results were reviewed with the manager. Certainly, at first, it stung a bit."
Pallozzi and the manager worked through each of the issues. In turn, the manager explained how she felt about the situation and how she was going to resolve the concerns voiced by her staff.
"I have had this same opportunity with two other managers during my tenure. It was difficult, but the end result is that retention has never been better," says Pallozzi. "The team is truly a functional team with compassion for each other, and with a true investment in the unit goals."
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