Hospital VIPs can empower access

Staff members take action instead of complaining

Do some patient access employees make a habit of complaining about various things, yet take no action to fix the problem? Patient access leaders at St. Margaret’s Hospital in Spring Valley, IL, learned that some personal attention from hospital VIPs can turn this problem around.

In 2013, the organization contracted with the Gulf Breeze, FL-based Studer Group. “This group educates everyone that the changes start at the top,” says Kimberly Happ, RHIA, director of health information management, records, registration, scheduling, and switchboard. “One of the skills that we learned early in the process is ‘rounding.’”

A different vice president rounds in patient access areas each month, asks staff members what is working well, and gives them a chance to report concerns. “Basically, we want to get to know our employees on a better level and pre-empt any problem before it snowballs,” she says.

Registrars also can interact with hospital leaders, including the president and chief financial officer, at quarterly employee forums. “The president has an open door policy, but how many employees ever go up and see him?” asks Happ.

The approach has made patient access employees speak up about longstanding issues instead of complaining to coworkers, reports Happ. “The wall has come down. They are not as afraid to say something,” she says. “They are not as inhibited to mention issues or concerns that they feel affect their area, the hospital, and more importantly, the patients. Instead of complaining about it, somebody puts a work order in.” Here are some changes made as a result of feedback from patient access:

• Unprofessional-looking signs were replaced in the emergency department.

Staff had noticed handmade paper signs taped to walls directing patients to use a different entrance-way or to ring the bell after 8 p.m., often with words misspelled, but no one had done anything about it. It wasn’t a registration issue directly, explains Happ, yet the signs conveyed an unprofessional image to all patients. “All it took was somebody from marketing to come down and make better-looking signs,” she says.

• Nursing leaders were educated on what information registrars need in order to fill out Advance Beneficiary Notices (ABNs) before a patient is transferred.

“They now understand that the hospital has to pay for the ambulance transfer if they don’t meet medical necessity,” says Happ.

• Patient access staff members were able to solve a problem of patients constantly asking the switchboard for change for a $20 bill.

Patients needed smaller bills accepted by cafeteria vending machines, and the problem was solved by getting the bank to place $5 bills in the ATM machine.

• Patient access staff put in a work order to have a frayed doormat replaced.

“It was a patient safety issue, it was ugly and dirty and needed to be replaced,” Happ says. “The very next day, it was fixed.”

• A frequently used restroom near a registration area was remodeled.

“We had a very ugly, outdated bathroom, used heavily by staff and patients, that we all complained about every day,” says Happ. Staff members assumed the president of maintenance knew about the problem and just didn’t do anything about it, but they learned this wasn’t the case. “How can you fix something you don’t know is broken? Within several months, the bathroom was totally redone,” she says.

• Staff were given wireless mice.

After Happ was told that staff wanted these to reduce clutter in their work space, she was able to obtain them within moments. “It took me longer to plug them in and put in a new battery,” she says. “They love having more room on their desks.”


For more information on hospital leaders interacting with patient access employees, contact:

Kimberly Happ, RHIA, Director, Health Information Management/Records/Registration/Scheduling and Switchboard, St. Margaret’s Hospital, Spring Valley, IL. Phone: (815) 664-1549. Fax: (815) 664-1169. Email: