Make sure evaluations are truly objective
Raise tied to performance
Registrars at Littleton (CO) Adventist Hospital have the opportunity to receive a "pay-for-performance" salary increase each year.
"We call it Performance, Feedback and Development," says Mark Bulow, registration supervisor. "The first half is based on whether staff met, exceeded, or failed to meet goals and results."
The second half is based on behavior expectations. Registrars receive scores of "exceed," "meet," or "needs improvement" for these seven behaviors:
- Compassion: Staff members are expected to display sensitivity and responsiveness to all persons in need.
- Respect: Staff must have good communication skills and interact well in teams.
- Integrity: Bulow says, "Here I am looking for accountability and being honest in a helpful way."
- Spirituality: Staff must acknowledge its central role in facilitating mental, physical, and emotional health in some patients. "I am looking for respect of different beliefs here. This is usually not an issue," says Bulow.
- Stewardship: To assess this area, Bulow asks the questions, "Is the registrar using the company's time wisely? Does he or she use our resources appropriately?"
- Imagination: "I am looking for someone who implements problem-solving solutions and shares new ideas," says Bulow.
- Excellence: The registrar must strive to exceed expectations for quality, customer service, and overall performance.
"We then use a matrix for each category. Employees can be scored as 'exceed-exceed,' 'meet-exceed,' or 'meet-meet,'" says Bulow. "From there, corporate determines the raise that each portion of the matrix will receive."
Registrars who receive a score of "exceeds-exceeds" typically receive a 4% to 5% raise, and those who receive a score of "meet-meet" typically receive a 2.5% raise. About 70% of associates are scored as "meet-meet," and about 10% receive "exceeds-exceeds."
Using actual numbers as goals, such as collection totals and consent audits, makes evaluations more objective.
"We let them know about these before the year starts. They know what percentages or numbers to hit, in order to either meet expectations or exceed them," says Bulow. (See related story, p. 35, on the specific metrics used by patient access leaders.)
Errors are eliminated
At Ronald Reagan UCLA Medical Center in Los Angeles, patient access leaders monitor a "bypass warnings" report each day. This shows the number of rules that were not encountered, or information that was missing when a particular staff member pre- registered a patient.
"These warnings are based off of the data that the billing department must have for the patient, in order for the stay to be billed and submitted correctly," says Smruti Patel, manager of patient access services. An additional report used pulls the number of accounts encountered by an individual staff member. Together, the two reports determine the employee's registration accuracy level.
"This method provides an objective way to assess the quality of each staff member's contribution to the patient access department," Patel says.
During quality reviews, staff are provided with their overall percentages, strengths, and opportunities for improvement. "They are then asked to provide feedback on items that may impact their performance, that management should be aware of," says Patel.
Staff was made aware of a way to "pull" information in the demographic section to fix errors in the subscriber and guarantor sections. "This resulted in many errors being eliminated," says Patel.
- Mark Bulow, Patient Access Supervisor, Littleton (CO) Adventist Hospital. Phone: (303) 734-3953. Fax: (303) 734-3936. Email: MarkBulow@Centura.org.
- Smruti Patel, Manager of Patient Access Services, Ronald Reagan UCLA Medical Center, Los Angeles. Phone: (310) 267-4255. Fax: (310) 267-3725. Email: SmrutiPatel@mednet.ucla.edu.