Access career ladder is new and improved
These changes were made to the patient access career ladder at University of Kentucky HealthCare in Lexington:
• The criterion for registration auditing was changed from measure of error rates in completing fields of a registration to denial rates by registrar.
"We moved to this approach to better align the work our registrars are doing with the organizational goals of reducing registration denials," says Courtney M. Higdon, director of enterprise patient access services.
Previously, managers evaluated particular fields for certain completion rates and values. That evaluation didn’t necessarily guarantee the claim wouldn’t get denied, however. "Now we are auditing our registrars based on their registration denials," says Higdon. "We are linking this performance to part of their overall annual performance evaluations."
• New requirements for performance evaluations and corrective action were added as criteria for promotion.
"We have taken deliberate steps through during this process to redefine this program to develop standard guidelines [that] managers across the organization can use to evaluate employees in these positions," says Higdon.
These guidelines are also quantitative metrics of performance. "They help address the challenges with subjective evaluations leading to organization variances in performance of staff in these positions," says Higdon.
Some of the performance metrics include standards of performance around delivery of service. "This is measured through an observation tool. We evaluate specific things we expect to see in any interaction with a patient or family member," says Higdon.
Additionally, there are metrics for registration and scheduling accuracy, completion of the Medicare Secondary Payer Questionnaire, and creation of duplicate medical records.
Staff members now have to complete additional training to qualify for promotion. "They must meet our standards for registration denials, demonstrate an above average’ result on their performance evaluation, and not have been on corrective action for 12 months prior to being promoted," says Higdon.
• The training requirements of the positions were redesigned.
"We brought them in line with current organizational goals, focusing more specifically on customer service as the most important role of the position," Higdon explains.
Patient access leaders worked with the hospital’s Office of Service Excellence to have a classroom training developed on service delivery, specific to the role of patient access. "Previous training was not-role specific. It was not a requirement of the position," says Higdon.
• Additional training is required for higher level team members, on leadership, mentoring, and process improvement.
"We expect our Level Two staff members to take on the responsibility of mentoring their colleagues," says Higdon.
The employees do not have supervisory positions, but they are recognized leaders within their teams. "They initiate discussions around improving workflows and processes unique to their areas," says Higdon.