Ask, `What's not working well?'

Taking action can boost morale

Morale of patient access staff has improved noticeably at Indiana University Health in Indianapolis, due to leaders "rounding for outcomes," reports Cortney Gundlach, CHAA, CHAM, director of Patient Access Services.

"Our leadership team is working hard on improving the morale in our department," she says. "I would attribute the positive changes to several factors including mutual respect and investing in our team members."

Rounding for outcomes is a successful tool only if two things happen, Gundlach says. The team members must communicate what their needs or ideas are, and the leader must follow up on the topics that are brought to their attention. "This fosters an environment of respect," she says. "A team with high morale creates a more inviting atmosphere. This transfers over to the interactions we have with our patients and their family members."

Formal rounding takes place on Tuesdays from 9 a.m. to 11 a.m., with managers, the director, and the executive director walking through their areas of responsibility asking these questions:

• What is working well?

• What is not working well?

• What tools or equipment do you need to be successful in your position?

• What ideas do you have to improve patient flow?

• What could we do differently to support our internal and external customers?

Here are two process changes that were made as a result of rounding:

• The patient access team at Indiana University Health Methodist Hospital suggested that leadership review the registration process for ambulance patient flow.

"Our evaluation showed redundancy in processes and the need for more equipment," Gundlach reports. The Emergency Department at Indiana University Health Methodist is a Level One Trauma Center and sees more than 320 patients a day on average.

"Patient access works closely with the clinical team as patients arrive. We were completing our process, and then the clinical staff members completed theirs," says Gundlach. Once the patient arrived at the bed, a second patient access team member had to print the appropriate paperwork.

"We decided to place printers in the ambulance triage area and train the clinical staff on completing a 'quick reg,'" says Gundlach. "These changes allowed the patient access team to be removed from the ambulance triage area and be better utilized within the ED."

• Team members communicated to department leaders that more patients are requesting cost estimates and other financial clearance information for their procedures.

The department is considering investing in price estimation software as a result of the feedback, Gundlach says.

"Currently, patient access does not have the technology to provide this information at time of registration," she explains. "We are collaborating with other departments to ensure we choose technology that supports multiple disciplines."