Use these metrics for staff evaluations
There is no mystery about how patient access employees are evaluated at Littleton (CO) Adventist Hospital.
"With each objective measure, we assign a weight, totaling 100%, and base their evaluation on that," says Mark Bulow, registration supervisor.
Collection totals are shared with staff on a weekly basis, and consent audit and accuracy scores are shared once a month. "The staff often asks how they are doing," reports Bulow. "I have noticed that associates are pressing more often for their stats and personal numbers." These metrics are used:
Collecting at least $5 from emergency department (ED) self-pay patients. (15% of total weight).
If staff collect from at least 18% of patients, they meet expectations. If they collect from 19% or more, they exceed expectations.
Individual collections (15% of total weight).
"We track copays and coinsurance taken from patients with commercial insurance," says Bulow. "If they have Medicare or Medicaid, we do not collect."
ED registrations that have commercial insurances or managed Medicare are totaled and compared with how many collections the employee had. If employees collect 40% to 49%, they meet expectations; 50% or more is scored as exceeding expectations.
Wait times for bedside registrations (10% of total weight).
"This is a team-based goal," says Bulow. "We measure the time it takes us to register a patient after the physician has signed up."
Decreasing the time by 10% to 19% meets the goal, and more than 20% exceeds the goal. "This holds everyone accountable for wait times," says Bulow. "People aren't pressured only to register their patients quickly. There is more teamwork."
In outpatient areas, managers measure the time the patient signs in until registration is started. "We want 92% to 96% of wait times to be under nine minutes," says Bulow. "More than 97% exceeds that goal."
Consent audit (20% of total weight).
"Here, we pick 10 accounts that each registrar has registered," says Bulow. "We then look at the consent and the patient bill of rights to make sure they are filled out completely and accurately."
Bulow looks for a signature, date, time, and that the employee checked off whether the patient wanted a copy of the hospital's privacy practices. "I recently made this part of the criteria for our employee of the month and saw the consent audit scores rise considerably," he says.
Meeting the goal requires a score of 95% to 99%, and exceeding the goal requires 100% compliance. "We actually had a handful of registrars get 100% last year," says Bulow.
Essential job functions (40% of total weight).
"This is our accuracy score on registrations," says Bulow. A score of 98% meets the standard, and 99% or more exceeds it.
"We also include our mandatory learning courses here," says Bulow. If these are completed on time, it doesn't affect the employee's score. If they are late on mandatory learning, which they have several months to complete, they will not meet the goal.
In outpatient areas, an Advance Beneficiary Notice (ABN) completion percentage rate is measured by registrar.
Completing 90% to 94% of ABNs meets the goal, and more than 95% exceeds the goal. "This was never a goal before, and our ABN rate was very low," says Bulow. "Now that it is being included on the review, the percentage increases are amazing."