Is excellent service always given? Observe staff and know for sure
Is excellent service always given? Observe staff and know for sure
Role is becoming more complex
Giving excellent customer service all the time sounds simple enough, but for most patient access departments, it's becoming pretty complicated. There's a lot more to the job than just being polite while getting all the information necessary to register a patient.
"It has become a little more difficult to do, in part because of the sensitive nature of the questions we need to ask patients," says Jana R. Mixon, director of patient access and central scheduling at Kettering Health Network in Dayton, OH. "The health care system has become more complex, and patients are often anxious. We can't assume that they understand why we are collecting information or all the rules about insurance."
"Front-end staff make a difference in the patient's view of the hospital stay," says Susan Pletcher, director of health information and patient access services at the Medical University of South Carolina (MUSC) Health in Charleston. "Registration staff are often the first people encountered by the patient."
This is where observing staff-patient interactions becomes important. "We find that direct, on-site supervision is a key element for ensuring that all patient and family interactions meet our standards," says Chris Robertson, manager of the centralized registration area at the University of Virginia Health System in Charlottesville. "We observe both openly and in less direct ways."
Access managers walk through registration areas as part of their daily routine, observing and listening to both staff and patients. "We also sit with staff periodically throughout the day," says Robertson. "We find that some staff perform at a higher level when they know they are being observed. Often, that higher level of performance becomes their norm."
While managers typically provide feedback only after the patient leaves, "at times, immediate intervention is the only way to ensure a positive outcome," says Robertson.
An observer can easily hear what is said by one of Kettering Health's registrars without being obtrusive, as the registration booths are open on one side. "I can put somebody in a booth right next to them and they can overhear everything," says Mixon. "To the patient, it looks like they are over there working, but we are actually doing a quality check and making sure that the service we provide is good."
'Hearing' a smile
At University of Virginia Health System, an audio monitor listening tool has been installed at each registrar's desk. Managers can easily listen to interactions with patients. "This has been of tremendous benefit in gauging the quality of their technical and customer service skills," says Robertson. "We use a checklist to determine the quality of each registration that we listen to. We provide immediate feedback to the registrar."
Managers listen for and assess the initial greeting, use of the correct patient identification practices, and collection of demographic and insurance information. They also want to hear pleasantries, such as "please," "thank you," and use of the patient's name in a respectful manner, throughout the interaction. "We also listen to the registrar's tone of voice," says Robertson. "Did we 'hear' a smile?"
These interactions are recorded, so they can be played back to staff at a later point in time. "We received approval from our legal office to do this," notes Robertson. "This allows us to congratulate them on a great interaction, and help them to 'hear' where improvements are needed."
All phone calls made by Kettering's registrars are recorded for quality monitoring. The department recently implemented new software that "listens" for specific words and phrases. A staff person must give his or her name, say "thank you," and ask the patient at the end of the call, "Is there anything else I can do for you today?"
Recordings are useful
Kettering's registrars are aware the calls are being recorded, and that managers may share the calls during staff meetings to give examples of good service or service that needs improvement. If the key words aren't used on a given call, that staff person is spoken to.
Managers also pay close attention to conversations with patients, anytime they happen to be nearby. "We have always been upfront with staff about this. Customer service is something that is difficult to measure," says Mixon. "So they know we are listening. Anytime that we are around, it could be the time that we take something back to them."
To let patients know who they are dealing with, all registrars are required to give their names. If a registrar is not introducing him- or herself, attention is called to this fact. On the other hand, if registrars are doing a particularly good job with greeting patients, they're held up as an example.
Calls are typically reviewed with a group of employees. In listening to their own voices, they can hear the positive and negative inflections that are present during a call. "A customer can hear if you are happy and willing to help, versus annoyed and distant," says Mixon. "It is important that we connect with our patients, both face to face and over the phone."
On one occasion, the department was consistently hearing that a specific physician was not getting the test that he was ordering, and he wasn't happy about it. "We were able to go through the calls and discover a couple of things," says Mixon.
The office's schedulers were not being consistent in what they were asking for. "And since we were getting different schedulers every time, we didn't pick up on those differences," says Mixon.
The schedulers were given some additional questions to ask when scheduling a test for this particular doctor. This ensured that the result he received was exactly what he needed to care for his patient. "We listened to several of these calls in our staff meetings, so that the schedulers connected with the physician's concern," adds Mixon.
Help, instantly
If one of Kettering's registrars is having trouble with an angry patient, or is stumped for an answer to a patient's question, a newly implemented instant messaging software product can come to their rescue.
"This allows us to type a message to a co-worker or supervisor on the screen, without a patient or caller knowing we are asking for help," says Mixon. "If somebody is having trouble with a call, we can coach them on a response and the caller can't hear us speaking."
Recently, a caller asked a scheduler some medical questions that she simply couldn't answer. When she told the patient not to have anything to drink the night before a test, the patient replied that she didn't understand why the test was needed in the first place.
Normally, this would mean putting the patient on hold and getting someone else on the line. "That information is not in the system. There is nothing in front of them to be able to answer that question," says Mixon. "Now, the senior scheduler can chime in and explain the reason why. The scheduler doesn't have to put that patient on hold, and is able to react more quickly."
Another caller became very upset, and the scheduler had a hard time handling this. "The team lead helped behind the scenes, so the patient didn't feel that they were being pushed off to another person," says Mixon.
[For more information, contact:
Jana R. Mixon, Director, Patient Access and Central Scheduling, Kettering Health Network, Dayton, OH. Phone: (937) 384-4541. E-mail: [email protected].
Susan Pletcher, Director, Health Information and Patient Access Services, MUSC Health, Charleston, SC. Phone: (843) 792-8136. Fax: (843) 792-8391. E-mail: [email protected].
Chris Robertson, Manager, Centralized Registration Area, University of Virginia Health System, Charlottesville. Phone: (434) 243-0177. Fax: (434) 243-0174. E-mail: [email protected].]
Giving excellent customer service all the time sounds simple enough, but for most patient access departments, it's becoming pretty complicated. There's a lot more to the job than just being polite while getting all the information necessary to register a patient.Subscribe Now for Access
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