Needless turnover? Put a stop to it

Pay isn’t always the deciding factor

If one of your best registrars is considering leaving patient access for a higher-paying position in another hospital department that offers better compensation and hours, there might be something you can do to change his or her mind.

“Pay is not always the deciding factor, and that is a good thing,” says Maxine Wilson, CHAA, CHAM, ambassador for the National Association of Healthcare Access Management (NAHAM) and former director of patient access at Methodist Medical Center in Oak Ridge, TN.

Wilson reports that when she surveyed members of her patient access staff, they often named “appreciation” as the number one reason for their dedication to a position.

After an experienced registrar turned down a position with the business office, she explained that her decision stemmed from the respectful way she was treated by Wilson. “Obviously, some turnover cannot be avoided,” says Wilson. “However, minor opportunities for employees to feel appreciated can oftentimes make the difference between a person staying in the area or transferring to another one.” Here are Wilson’s own strategies for reducing turnover:

• If an employee is not performing as expected, ask what you can do to help.

Wilson took aside one poorly performing new hire approaching her six-month evaluation and simply asked, “Is there something I can do to further help you with your performance?” “She stated that other people seemed to avoid her and didn’t want to help when she needed it. She felt intimidated by asking,” says Wilson.

Wilson then asked a senior patient access employee to take the new hire “under her wing” for a few weeks and make a special effort to answer any questions she might have. “She was enthusiastic after that, and we had a celebration with soda and cookies when her probation period ended,” says Wilson.

• Commemorate birthdays and hire anniversary dates.

“A small cupcake is very inexpensive, but it shows the employee that you are aware of their special dates,” says Wilson.

• Pay for the application for certified healthcare access associate (CHAA) examination, with the condition that the employee stays in your department for at least one year.

Registrars feel a great sense of pride in having “CHAA” on their badge, Wilson explains. “Employees in health care facilities often have many letters after their names on their badges because of the certifications that are required for that position,” she says. “This offers the opportunity for the front-end to have credentialing after their name, as well.”

• Post photos of staff with special headlines acknowledging something they are best at.

“Label your bulletin board any way that you choose — whatever you want them to strive for,” says Wilson. Possible headlines are “Best Quality Assurance,” “Most Money Collected,” “Lowest Call-in Rate,” or “Highest Attendance.”

“Explain the criteria at a staff meeting, so there is no jealousy or misunderstandings of how this happens,” cautions Wilson. “Otherwise, you may cause more harm than good.”

• Arrange for hospital administrators to thank staff members personally.

Wilson once invited the hospital’s chief financial officer (CFO) to present an employee with her CHAA certificate during a staff meeting.

“This was amazing for the employee to have the CFO personally hand them their certificate and pin,” she recalls. “I have seen them get tears in their eyes from receiving this, and especially from an administrative leader.”


For more information on improving retention, contact:

Maxine Wilson, CHAA, CHAM, Clinton, TN. Phone: (865) 898-7097. Email: