A simple audit can correct dissatisfiers

Staff average 90% or better

Do staff members mention a patient’s name — not just once, but three times — during the registration process? This step is something that all patient access employees are expected to do at St. Anthony Hospital in Lakewood, CO, says Tammy Casados, manager of patient access.

Patient access associates are required to complete the Studer Group’s AIDET Five Fundamentals of Patient Communication course within the first 30 days of employment and annually as a refresher course. (For more information, see resource box.) The course requires staff members to do the following:

Acknowledge the patient.

Introduce themselves.

• Tell the patient how long the duration of registration will be.

Explain the registration process, any necessary forms that need to be completed, collections of any amount due, and any delays. For example, staff may tell a patient, “We are waiting for your room assignment,” or “X-ray is running a little behind today, but we will keep you informed of any longer delays.”

Thank the patient and ask, “Is there anything else I can assist you with today?”

“This is how we build trust and communication with our customer, who may be feeling a little nervous, anxious, or vulnerable for their visit at our facility,” says Casados.

HCAHPS score is goal

In February 2012, the department implemented a First Impression Team and a monthly audit in outpatient registration areas, with the goal to improve its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score, which is publicly reported by the Centers for Medicare & Medicaid on the Hospital Compare website (www.hospitalcompare.hhs.gov).

Managers complete an audit form on whether staff took action steps during an observed patient encounter, such as standing up from their desk to greet the patient. Staff average 90% or better on the audits. “We view the registrar and listen to their conversation with the patient and family,” says Casados. “After the patient is escorted to their procedure, we talk with the registrar on what we viewed.” (See list of actions managers look for when auditing outpatient locations, below.)

Audit staff members for these 5 things

Patient access managers at St. Anthony Hospital in Lakewood, CO, audit all registrars at each outpatient location monthly, and expect a score of 90 points or higher, says Tammy Casados, CHAM, manager of patient access. They check for these five things:

1. Did the registrar stand up when the patient presented themselves? (Yes = 20 points, no = 0 points)

2. Did the registrar introduce themselves to the patient? (Yes = 20 points, no = 0 points)

3. Did the registrar use the patient’s preferred name at least three times during the registration process? What name was used for the patient? (Once = 5 points, twice = an additional 5 points, three times = an additional 5 points)

4. Did the registrar use a personal touch in the conversation? What was the personal touch? (For example, “How is your day going?” “That is a very pretty scarf,” “I was born in Minnesota as well.”) (Yes = 20 points, no = 0 points)

5. Did the registrar end the conversation by saying “Is there anything else I can do for you?” (Yes = 20 points, no = 0 points)

Recently, a new registrar in the hospital’s main lobby scored a disappointing 55% out of 100% on the audit. Casados told her immediately afterward that she didn’t complete a personal touch with the patient, she only used the patient’s name twice, and she didn’t stand up to greet the patient. Casados reviewed the list of action steps to follow.

“The next time I completed an audit on her, she was sitting down when the patient walked into the office,” says Casados. “All of a sudden, she jumped up, extended her hand and gave her name. It was like a light bulb went off.”

The registrar got 100% score on the audit, and the patient left her office looking relaxed while they talked about the upcoming Bronco game.

At first, staff found it difficult to use the patient’s name at least three times, but there are many ways to fit this into the conversation, says Casados. For example, staff might say, “Mary, how is your day going so far?” “Mary, that’s a beautiful necklace,” and use the patient’s name again when going over the forms to sign.

“They now find it very easy to do this, once they find out how they patient wants to be addressed,” she says.


For more information on auditing patient access employees, contact:

Tammy Casados, CHAM, Manager, Patient Access, St. Anthony Hospital, Lakewood, CO. Phone: (720) 321-0428. Fax: (720) 321-0430. Email: TammyCasados@Centura.org.

• The AIDET Five Fundamentals of Patient Communication is a video-based training resource that trains leaders to reduce patient anxiety, improve patient compliance, improve clinical outcomes, and increase patient satisfaction. The cost, which includes a 2-hour DVD, implementation guide, 50 participant guides, and 50 pocket cards, is $2,150 plus shipping. For more information, contact Fire Starter Publishing, Gulf Breeze, FL. Phone: (866) 354-3473. Fax: (850) 916-3532. Email: info@firestarterpublishing.com. Web: www.FireStarterPublishing.com.