Spend an hour in registration areas

Managers report improved morale

Administrative rounding in patient access areas "has proven hugely successful with our staff," reports Keith Weatherman, CAM, MHA, associate director of service excellence for corporate revenue cycle for Wake Forest Baptist Health in Winston-Salem, NC.

"When visited one on one, staff feel free to offer great suggestions," Weatherman says. "They feel good that the higher up’ folks care."

Weatherman has heard dozens of different concerns while rounding. He has been able to resolve nearly 100% of the issues raised, which have ranged from tools that are needed, issues with management, training needs, and process improvement.

Each morning, Gloria Vargas-Gonzalez, registration supervisor at Elmhurst (IL) Memorial Healthcare, rounds with her staff in the emergency department (ED), outpatient, surgery, endoscopy, and admitting areas. She spends from 40 to 60 minutes rounding every day.

"I start with some simple conversation to meet and greet the staff each day," says Vargas-Gonzalez. "I think it makes them feel important and that they work in a caring environment."

Vargas-Gonzalez first asks how the employee’s day is going, and if he or she needs any kind of help. "I also assess the volume and staffing, to make sure we are providing excellent customer service," she says. (See related story, p. 69, on how staffing concerns can be resolved with rounding.)

If Vargas-Gonzalez doesn’t round in a certain area on a particular day, the employees let her know she was missed. "We get to say hello and have a simple conversation. It’s one of the things that the employees look forward to," she says. Here are some concerns Vargas-Gonzalez has resolved during rounding:

• Outpatient registration staff reported delays in appointment scheduling due to misdirected patients, and patients presenting without a written order.

"The amount of time spent resolving these issues varies and can be time-consuming, causing a delayed reaction for other appointments," says Vargas-Gonzalez. "If needed, I will help register patients that may be waiting."

At times, technicians are unable to perform a test because there is no physician order. In these cases, Vargas-Gonzalez apologizes to the patient and gives assurance that staff are working to correct the problem. Next, she calls the provider’s office to let them know the patient’s test will need to be rescheduled if the order isn’t obtained.

"People have choices, and if we are a repeat offender they will look elsewhere. We don’t want that," she says.

• In the ED registration areas, Vargas-Gonzalez continually looks at the tracking board to assess volume.

She assists with registrations if needed, or adjusts staffing to meet the department needs.

• Vargas-Gonzalez answers any questions registrars have about insurance.

"If they code something incorrectly, they are able to quickly change it on the spot after talking to me, rather than the claim going through billing and getting rejected," she says.

• Vargas-Gonzalez recently helped staff when a payer’s system was down, which made online verification of benefits impossible.

"If it doesn’t come back quickly that the patient has eligibility, then I just ask them to document the account," she says. Then when the system goes back up, we are able to capture the eligibility afterward."

Vargas-Gonzalez called the payer right away to report the problem. "They were then able to alert us when the system is recovered, so we knew we are able to view the eligibility again," she says. "That has a big impact on our financials."

• Vargas-Gonzalez got approval for desktop scanners that were repeatedly requested by staff.

"Right now, we are doing everything on paper, and at times, it doesn’t come out correctly," she says. With the new scanners, the order and insurance card are scanned into the system.

• At times, staff members ask Vargas-Gonzalez if they can meet with her privately. These discussions often involve issues with coworkers, such as tardiness, but she is often able to head off problems by informing colleagues in advance if one of their colleagues is running late.

"I let them know something is going on. Someone may have a doctor’s appointment and isn’t going to be back in time," she says. "It’s important to keep everyone informed."

SOURCES

• Gloria Vargas-Gonzalez, Registration Supervisor, Elmhurst (IL) Memorial Healthcare. Phone: (331) 221-3248. Fax: (331) 221-3773 Email: gvargas@emhc.org.
• Keith Weatherman, CAM, MHA, Associate Director, Service Excellence, Corporate Revenue Cycle, Wake Forest Baptist Health, Winston-Salem, NC. Phone: (336) 713-4748. Fax: (336) 716-3153. Email: kweather@wakehealth.edu.