Nobody is training them’
Is web-based training in access services skills the best way to keep ancillary staff motivated and on the job? That’s the contention of one company that recently has added a new twist to its educational offerings.
"We’ve made our focus hospital ancillary staff because nobody is training them," says Susan Juers, director of training and education for John Putnam International in St. Petersburg, FL. "Knowing that those [access] representatives take in 70% of a hospital’s revenue but are the poorest-trained staff with the highest turnover, we [asked], What can we do to minimize mistakes, bring down the error rate?’"
John Putnam has been offering teacher-led training for about five years, she notes, and went live with its web-based program on June 1, 2002. The split between the two programs is about 75/25 now, with the primary focus on web-based learning.
"The idea was to do web-based training, but to make it education, as opposed to training," Juers adds. "We wanted to create an educational tool, so it wasn’t going to be like regular training where they throw some information at you, you take a test for comprehension, and then you walk out and are on the job."
The key to reducing turnover, she says, is treating staff well, "as if they are experts. We’re providing the means for them to demonstrate what they know, build on that, and then apply it before they go on the job."
The courses that make up the company’s Patient Access Success Training (PAST) are divided into subtopics, or modules, she explains. "We make it all measurable. Instead of just taking a topic like managed care, we break it down into all the related skills, and each of those becomes measurable."
Students complete a pre-assessment before starting each module, Juers says, which creates a baseline for learning. "If they know most of the material and know it well, they don’t have to go through that module. [The program] takes them only to the parts they need to know."
At present, there are a total of 24 patient access and patient financial courses, she adds, as well as compliance and management courses. "We now have all of the patient access courses posted on the web site, with patient financials to follow."
The management courses, she notes, cover such topics as "Budgeting for Dummies" and behavioral interviewing.
Anne Dolph, CHAM, MS, manager of patient registration at Advocate South Suburban Hospital in Hazel Crest, IL, says she plans to use the program for new hires, not for existing staff, and likes the fact that the company will customize its product to meet her needs.
"They looked at our turnover and figured we would have 10 individuals in a year who could go through seven or eight courses," Dolph adds. "You can mix and match. I liked their information on confidentiality, for example, and their approach to customer service. There is also a module on the revenue cycle that shows the importance of what [access representatives] do on the front end."
While she would expect a course on medical terminology to focus on clinical information, such as symptoms of illness, she says, "their course includes billing and insurance terms and general health care terms. That’s information that we don’t go into with [new staff], but I know it will make them stronger access employees."
Her department does not have a separate training program, Dolph explains, so the instruction that new employees typically receive is focused on how to enter information onto the computer screen and the myriad of documents that access employees must handle. "We don’t get into the general health care information that would increase their understanding of their place in the system."
The courses are set up so that students must pass at a mastery level of 90%, Juers says, but that, too, can be customized. "We can change it to 100% or 80%."
If the employees show their mastery of a module in the pre-assessment, they don’t have to go into it, but do have access to the material, she points out. "If they don’t pass the pretest, they have to go in and do the presentations. If they skip any part, the system won’t recognize that they’ve completed it, and they won’t get a certificate, even if they pass the post test."
That means, Juers adds, that students "can’t skim through it and if they don’t know something, they can’t fake their way out of it."
The program’s reference section allows employees who are back at their workstations to access information from the courses they’ve completed, she notes. "If they don’t remember what the 72-hour rule is, they can go to the reference section and type that in."
There also is an electronic notebook, and a chat room where students can discuss issues in real time, Juers adds. "We have a professor who can share information and lead live chats. He recently did one on HIPAA [Health Insurance Portability and Accountability Act]."
The cost of the educational program generally is from $55-$75 per user, which includes three courses and a year’s access, she says. For managers who want to show a return on investment, she says, there’s a way to track and measure the improvement of those who have completed the program.