Duplicate reg? Fix it right away
It’s not uncommon for parents to give registrars the correct child’s name but another child’s birthday, due to the extreme stress of bringing their child to the hospital, says Kira Bowers, MBA, manager of patient access services.
"Another reason we see a lot of duplicate registrations is because registration staff select a patient that is close to the demographic information given to registration," says Bowers.
When patient access leaders Children’s Hospital of Pittsburgh of UPMC began tracking duplicate registrations in February 2013, there were 36 a month. This number decreased to just seven in May 2013, due to changes in how members of the registration staff search for patients.
"Many duplicate registrations were due to human error," reports Bowers. "We looked at how a registrar enters a registration and what could reduce the risk of selecting the wrong patient due to close demographic information."
Now, registration staff sees the patient’s address in addition to the name, date of birth, and social security number. "We also have built in logic that will give the registration staff a probability number’ that the patient they searched for, and the results they are receiving, are in fact the same patient," Bowers says.
Duplicate registrations can occur for a variety of reasons, only some of which are avoidable, says Lolita M. Tyree, CHAM, MSW, patient access manager at Riverside Regional Medical Center in Newport News, VA. "Relying on patients to provide you with accurate information is a vital part of this position. When that process fails, the patients are put at risk," says Tyree.
Duplicates can occur when a patient presents as an unknown, when a clerical error is made in a name spelling or date of birth, and also when a patient purposefully presents false information. (See related story, below, on how to address suspected fraud.)
"Paying close attention to details is a major way of identifying these duplicates before they are able to compromise patient care," says Tyree. "It takes a registrar asking the right questions and stopping the registration process in order to make certain they have the correct patient every time."
Paying close attention to details is the best way to identify duplicate registrations before these errors compromise patient care, Tyree emphasizes. "It takes a registrar asking the right questions and stopping the registration process in order to make certain they have the correct patient every time," she says.
Education on errors
Following up with staff about errors resulting in duplicate registrations is critical, says Bowers.
"Leadership in patient access take errors that staff made and re-do a patient search with them to see what happened and what went wrong," she says. "This prevents errors in the future."
When patients fill out a sheet of paper with their information to check in, registration staff can misread the information or simply try to register the patient too quickly.
"When we find the error, we pull the staff member aside. We go through the registration again with them, to show how they can prevent the same mistake in the future," says Bowers.
• Kira R. Bowers, MBA, Manager, Patient Access Services, Children’s Hospital of Pittsburgh of UPMC. Phone: (412) 692-8293. Email: Kira.Bowers@chp.edu.
• Lolita M. Tyree, CHAM, MSW, Patient Access Manager, Riverside Regional Medical Center, Newport News, VA. Phone: (757) 594-3334. Fax: (757) 594-3069. Email: Lolita.Tyree@rivhs.com.
false info in ED
Drug seekers that present to the emergency department commonly present with false information, says Lolita M. Tyree, CHAM, MSW, patient access manager at Riverside Regional Medical Center in Newport News, VA.
"There was one instance where we found a young lady had presented with more than five aliases in a few month’s time," says Tyree. "The red flag presented when one of the registrars recognized her and knew her by a different name from a previous visit to the facility."
By paying attention to small details, registrars were able to identify that she had many similarities in her alias registrations, including next of kin information and dates of birth. "We also noticed she had a pattern of how often she would present to the emergency department and the times of day she frequented," says Tyree.
Registrars followed facility protocols for red flag alerts. "She was arrested on site and escorted from the facility," says Tyree. "It’s my understanding she later was charged with providing false information."
If fraud is suspected, registrars ask patients "Have you been seen here before?" or "Is there another name you could have been registered by?" These questions often trigger the patient to repeat their information. "The registrars are able to notice the differences in how they may repeat their information, or if they’re stumbling over their Social Security number or date of birth," says Tyree.
Staff recently started taking a photo of patients presenting with no identification. "This, too, has helped to deter many patients from giving false information," says Tyree.