One person handles all needs of patient

Callers deal with experts

If a patient was coming in for a scheduled procedure at Spectrum Health in Grand Rapids, MI, he or she would receive 2-5 calls on average from various employees.

"We had a typical pre-encounter experience," says Jennifer Nichols, director of patient access. "That's not to say it was bad in any way. We were consistently performing well against peer hospitals and industry standards."

In 2011, a new process for scheduling was piloted with the hospital's radiology department, based on an "expert pod" of individuals able to verify insurance, schedule services, perform clinical pre-encounter services, pre-register patients, and offer financial assistance. In addition, the roles of "scheduler" and "registrar" were combined.

"We combined all of the pre-arrival resources, clinical and nonclinical," says Nichols. "That sounds so much easier than it actually is."

Nurses and a radiology technician are included in the pod, in additional to non-clinical staff. "For certain services and modalities, nursing pre-arrival screening and support is essential," says Nichols. "In addition, the benefit of having clinical resources immediately available to schedulers has been key."

Members of the pod team sits together so they can assist each other, and they cover for one another during breaks and lunch. "The radiology department is physically separate from our scheduling department," Nichols says. "At times, we would schedule something, but upon department review, we may find that they would have recommended a change or questioned the order."

Most pods consist of four scheduling/registration staff and a nurse, while some are a little larger, depending on the service line they serve. "To have instant access to that level of expertise and support has resulted in a far more efficient workflow and opportunities to expand the scheduler's knowledge," says Sam Mulliken, senior process engineer at Spectrum Health.

Experts on the line

Nichols says, "Certain functions are either more appropriate or are required to be done by licensed clinical staff. We wanted to make sure that if a case required a conversation with a nurse, for example, that the nurse was also able to schedule the event."

Patients can be preregistered by either a nurse or a scheduler, who are able to handle booking, rescheduling, giving clinical instructions, and giving directions.

"It's not a massive call bank where you may be talking to any one of 200 people who may schedule oncology on one call and radiology on the next," says Nichols. "The patient is talking to somebody who does this day in and day out."

The pod nurses were moved from the hospital to the business service center, and some found this transition difficult. "Even though they are doing the same kind of work, it feels different when you don't go to work in a hospital every day," says Nichols. Because the nurses were concerned about losing touch with patient care, they spend part of their time in clinical areas instead of working out of the business services center full-time.

"I was initially concerned that the nurses would not stay up with their expertise if we rotated them, because scheduling isn't easy," says Nichols. "But it has worked out exceptionally well. The nurses stay skilled in both the ongoing changes in their clinical areas, as well as those in scheduling."


For more information on a patient-friendly scheduling process, contact:

• Sam Mulliken, Senior Process Engineer, Spectrum Health, Grand Rapids, MI. Phone: (616) 486-2589. E-mail:

• Jennifer Nichols, Director, Patient Access, Spectrum Health, Grand Rapids. Phone: (616) 308-4119. E-mail: