New access technology? A golden opportunity

Open up a dialogue

If your hospital is switching to an electronic medical record (EMR), this change is an excellent opportunity to start a much-needed dialogue with clinical areas.

"It opens up a whole new way of looking at things. You have the chance to throw out old traditions that aren't working and resolve some important issues," says Barbara Snodgrass, patient access manager at Mount Hood Medical Center in Gresham, OR.

All of Mount Hood's departments are meeting to discuss the implementation of an EMR. "You need a lot of education between the departments, including access, so everyone understands how this new software is going to work," she says. "You don't want the patient to pay the price for a lack of communication."

For example, clinical staff members specified at exactly what point tracking boards are updated to show the patient is ready for discharge, and patient safety issues were discussed regarding clinical staff printing out their own patient labels for lab draws or wristbands, instead of waiting for patient access staff to do so. Questions such as "Are there time constraints for the clinical staff to do this?" and "Do we need more patient access staff to accommodate the new changes?" were addressed.

"Small changes can have a big impact," says Snodgrass. "It is vital to re-establish roles and responsibilities so everyone can be on the same page."

Decisions need to be made about whether nurses or registrars will enter appointments in the EMR, she adds, which brings up the question of whether additional training is needed for either area. "There may be something that patient access can do to help the nurse set up the orders so that the process is seamless for the patient," says Snodgrass. She suggests you take these steps:

• Be clear about every step in a process.

"Talk everything through. At what point in the process is an order is going to be faxed and by whom?" advises Snodgrass. "Don't make assumptions on either side."

• Have joint meetings when rolling out a new process or technology.

During the planning process for opening a new children's hospital, Snodgrass gave input on customer service from a patient access standpoint. "One issue that came up was how much space is needed for an area where an upset patient can meet with a patient advocate," she says.

• Address technology glitches.

Software problems can cause tension between clinical areas and access, as when a patient's surgery is scheduled on one system but the pre-surgery blood work is entered into a different system.

"There may be duplicate accounts because the software isn't interfacing well," says Snodgrass. "That sets you up for a lot of blame going back and forth — something clinical and patient access staff don't want."