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Web-based delivery is where the future lies for effective training of access personnel, suggests Jeanne Hughes, CHAM, regional quality assurance (QA) and training manager for access services at Providence Health System in Portland, OR. "What we’re really looking at is how can we reach people on alternate shifts and make sure they get the information that they need," says Hughes, who oversees a six-person QA and training department that provides comprehensive, ongoing training support for access personnel. "One of my projects is to investigate web-based [training programs]. That is what I want to see for us."
The trend as she sees it, Hughes explains, is more toward "learner-directed training, rather than always have the trainer standing up talking."
Compliance training is available on the Medicare web site (www.hcfa.gov), which prompts users through various screens to find areas where they have deficiencies, she notes. "Their technology can then send your test results back to [a designated recipient]."
But while Hughes sees the value of some standardized training at a national level on topics such as confidentiality and Medicare Secondary Payer issues, "the neat thing is when you can customize it," she says. Providence, for example, would benefit from specialized Intranet training on the HMOs in its area or on the Oregon Health Plan, she says. "The way I see it, there would be an icon on your desktop [computer]," Hughes adds. "When there are no patients around, or [after hours], you come in and click on the icon. It takes you into the program, which leads you through the pre-test, lecture format, post-test, and gives you feedback. If there’s a low score, you know you need to do it again."
There would be the option, she points out, of designing a training program for a specific insurance plan, perhaps one that is causing problems for registrars. An organization called the American Society of Training and Development (ASTD), which has a web site at www.astd.org, Hughes adds, "is on the cutting edge of training and development. That’s where I learn a lot about how to take our training to the next level, about presentation skills and how not to do the same old thing." In Portland, she says, there is a subgroup of ASTD that focuses on nothing but web development.
The piece of her plan for web-based training that she isn’t yet sure about, Hughes notes, is whether it can be done with current staff. "That’s one of the things I have to investigate this year. Can we take this on? At the idea level, it makes a lot of sense to us."
Providence’s Access Continuing Education, a daylong program designed to provide access staff with the latest information on customer service, compliance issues, and insurance changes, among other topics, began its second year in January 2001, she notes. (See Hospital Access Management, September 2000.) New this year are two other QA and training initiatives:
• A mentoring program. "When new employees get on-site," Hughes explains, "there is a designated mentor who works with them in addition to the supervisor. It’s like the star of the department — someone who can help them on the practical side." Plans are to provide some sort of compensation for the person who does the mentoring, she adds. "We want to do everything we can to help our employees be successful."
• A support group for the access employees who serve as notaries. At Providence Health System, Hughes notes, the access department provides the notaries public that are needed when, for example, a patient needs to sign a financial power of attorney. Providence pays for the training and certification for these individuals and provides the test that is required, she adds.
"It’s part of being a registrar, that they may be asked to do this," Hughes says. "Most of the time, it’s cut-and-dried — they know the requirements, but there can be a tough situation. Maybe a daughter is pushing her mom to sign [a financial document], and you realize the mom is confused."
Helping these notaries learn how to deal with family members and other providers, and to explain, for example, that they are not able to perform a particular function at that time, is one of the reasons why a support group is important, she says. "It just provides educational opportunities, and a chance to network with other notaries, so that when you get into a sticky situation, you know who the others are."