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Put a stop to chronic complaints from staff
Ask them for solutions
At one time or another, every patient access manager has come across a staff person who habitually complains, spreading negativity to other employees. "A constantly complaining staff member can cause the entire department to feel burdened by their complaints," says Melinda Clark, RN, CHAM, director of admitting at University of Kansas Hospital in Kansas City. "It can affect teamwork negatively. The staff member will often be avoided by their co-workers."
Complaints also can diminish patient satisfaction for the entire department, if patients and family members hear the staff member's gripes.
Clark encourages staff who have complaints to come up with solutions. "I empower them to implement those solutions, if they are reasonable," she adds.
One way of doing this is to involve the complaining staff member in meetings and groups. "They can provide input and have a say in what happens in our department," says Clark. "Encourage the employee to participate in process improvement initiatives. Give them a voice in department changes."
However, if constant negative comments are affecting patients, families, or internal customers, Clark says "it would be a disciplinary situation. Also, if they do not respond to coaching and requests to participate in the department initiatives, and they continue to complain excessively, it would warrant a disciplinary situation."
Vicki Lyons, patient access manager at Baptist Hospital East in Louisville, KY, acknowledges that for patient access departments, retention and good morale "is always a challenge."
"A lot of times, patient access is a starter area for employees to get their foot in the door," says Lyons. "I always say it takes a good year to learn all aspects of registration and be efficient. It is not a position that we want to constantly keep rotating employees through."
From the staff member's perspective, in fact, there may be a lot to complain about. "Patient access is where everything starts. Because of that, a lot of times when information is entered incorrectly or a patient complains about an issue, it is thought to have happened when the patient first came in," says Lyons.
Since new employees have a lot to learn, it often seems to them that they are being picked on when they first start in the department, explains Lyons.
To keep complaints to a minimum, the department uses several approaches. There are levels that an employee can move up to once he or she has the required knowledge and meets certain other criteria. "This gives the employee something to work toward," says Lyons.
"WOW" cards can be filled out by colleagues or customers, which let employees know they have done an exceptional job. And perhaps most importantly, staff always receive the benefit of the doubt.
When staff make errors such as entering an incorrect doctor's name or giving out incorrect information, Lyons always asks for the employee's input first. "I never insinuate that they are at fault. I always want to hear what they have to say," says Lyons.
Sometimes the situation is completely different than it seemed at first glance. Or, staff may have a reasonable explanation for their mistake, such as having taken information from a run sheet because the patient was unconscious.
Whatever the reason for the mistake, Lyons always puts the focus on the patient. She explains why it is important that the correct information is entered, or gives staff pointers on how to address certain issues that may arise with a patient.
"I also try to pat them on the back for a job well done," says Lyons. "It's always nice to hear good comments and not just the complaints." If she sees a good note that was made on a patient's account, staff get an e-mail complimenting them on it.
For instance, something on an account may look incorrect, but there is a detailed explanation about why the information was entered the way it was. It could be a note about why no Medicare is on file for a patient over 65.
"I always tell the staff that the note screen is their best friend when it comes to a registration," says Lyons. "Any registration that is not the norm should always have a note explaining why the information was not obtained, or why the registration was registered the way it was."
[For more information, contact: Melinda Clark, RN, CHAM, Director of Admitting, The University of Kansas Hospital, 3901 Rainbow Boulevard, Kansas City, KS 66160-7220. Phone: (913) 588-5876. E-mail: MCLARK5@kumc.edu; Vicki Lyons, Patient Access Manager, Baptist Hospital East, 4000 Kresge Way, Louisville, KY 40207. Phone: (502) 897-8159. E-mail: Vlyons@BHSI.com.]