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Maximize benefits of access career ladders
Be clear about criteria
Career ladders can be an excellent way to improve retention in your patient access department. However, there are some pitfalls to avoid. "Career ladders must be current and relevant to the job," says Holly Hiryak, MNSc, RN, CHAM, director of hospital admissions and access services at University Hospital of Arkansas in Little Rock. "There may be complacency if [employees] are not goal-driven with measurable roles and responsibilities."
Some career ladders focus on accuracy and speed without taking individual behavior into account, says Hiryak. She recommends the following:
• Promote staff based on objective criteria, such as accuracy, quality, attendance, and productivity.
• Be clear about responsibilities that are not measurable, such as customer service.
Otherwise, staff may see patients as customers, but not other departments. To address this, Hiryak recommends explaining to staff the difference between "on-stage" and "off-stage" behaviors.
• Align with human resources to ensure that the program meets facility requirements.
For instance, the organization may have monetary restrictions, or limitations on bonuses or incentive pay.
• Define the reasons for developing a career ladder.
Your goal is to establish clarity for all involved, from development to implementation. "A career ladder provides an opportunity to develop individuals from novice to expert," says Hiryak. "There is a minimum level of achievement expected. No one can opt to remain at the novice level."
The career ladder should not be based on years of experience, adds Hiryak. "Just because you have been in a role for 10 years does not necessarily mean you are an expert," she says. "This must be demonstrated through behaviors and annual competencies."
Courtney M. Higdon, director of enterprise patient access services at UK HealthCare in Lexington (KY), says the organization has focused "very intently" in recent months on redesigning patient access to clinical services.
"We are a large academic medical center with a two-hospital system and a significant multidisciplinary specialty group practice," says Higdon. "Just last fall, we launched our patient access center, which schedules patient appointments and pre-registers their visits. Three factors drove us to pursue this model."
Those were: low patient satisfaction with access, inability to effectively facilitate appointments for referring physicians, and structural inefficiencies and turnover in scheduling and registration personnel.
"At the patient access center we have created a career progression opportunity for personnel in these positions," says Higdon. "We have begun to develop a significant training and on-boarding program, the Access Academy, as well."
The career progression program serves to offer new patient access personnel a true opportunity to advance within the organization, preparing them for a number of different health care career tracks.
"The Access Academy will serve to bring patient access staff into the organization with a foundational knowledge and perspective on the entire enterprise," says Higdon. "It will serve to provide continuous professional development and growth opportunities."
The goal is to have staff understand the value of their role in the patient experience and the revenue cycle. "Having an appreciation of one's value within an organization fosters a stronger commitment and individual performance," says Higdon.
[For more information, contact: Courtney M. Higdon, Director, Enterprise Patient Access Services, UK HealthCare, University of Kentucky, 800 Rose Street, Lexington, KY 40536. Phone: (859) 257-6780. E-mail: Courtney.Higdon@uky.edu; Holly Hiryak, MNSc, RN, CHAM, Director, Hospital Admissions/Access Services, University Hospital of Arkansas, 4301 W. Markham, Little Rock, AR 72205. Phone: (501) 686-8170. Fax: (501) 603-1243. E-mail: HiryakHollyM@uams.edu.]