Cross-train staff for 'good turnover'

Well-trained registrars moving to a different area of the hospital might be something you'd never wish for, but this process is encouraged by Colette Lasack, MBA, executive director of revenue cycle at Gundersen Lutheran Health System in La Crosse, WI.

"We are very open that a lot of our jobs are more entry-level jobs for the organization. We take a lot of pride in growing people up and out of here," she says. "We embrace the fact that we are a feeder system. We don't want people to think they are trapped in patient business services forever."

Having former patient business services staff positioned in other hospital areas helps the department overall, according to Lasack. "If we have people with revenue cycle knowledge in other areas, it only makes us stronger," she says. "When we have to roll something new out, we have planted seeds out there that can help us."

Six years ago, a career ladder was implemented in patient business services, with certification and education requirements clearly outlined. "We wanted people coming in to say, 'I'm in a place that believes in my growth,'" says Lasack. "When a job opens up, they're ready to move to that level, whether in our department or other parts of the hospital."

The department averages 2% to 5% turnover annually, reports Lasack, with staff moving to information systems, compliance, nursing, and human resources, "but it's good turnover. It's a different mindset."

There is no better way to get staff to understand the overall revenue cycle than to have them work in different roles, she explains. "We encourage job shadowing to satisfy people's interests. This helps them understand how the work they are doing impacts different areas," says Lasack. "If I'm sitting in a hospital admissions office and I get the wrong insurance, what happens down the road?"

After staff work in multiple roles, she adds, they tend to become solution finders rather than just reporting a problem.

"They become better problem solvers. That really helps strengthen our teams," Lasack says. "There's nothing better than having somebody on staff who has worked in at least three different parts of the revenue cycle."


For more information on cross-training access staff, contact:

• Colette Lasack, MBA, Executive Director, Revenue Cycle, Gundersen Lutheran Health System, La Crosse, WI. Phone (608) 775-4370. Fax (608) 775-1033. E-mail: