Are access employees struggling with new skill sets? Don't let them fail

It's not one size fits all

Recent changes for patient access staff at BayCare Health System in Tampa, FL, include registration kiosks, palm vein biometric devices, and new consent forms that all patients have to sign.

Patient access staff members were trained on every one of these changes, but even experienced registrars needed one-on-one training in some areas, reports Tammy A. Scott, CHAM, a patient access service manager in the Emergency Center. To be sure staff can keep up with all of the new skills that are required, BayCare's Central Business Office offers training "far beyond the 'new hire' classes," she says, such as specialized classes on cash collections and insurance verification.

"Many healthcare systems are experiencing a decrease in patient volume. When patient volumes drop, so does the need for FTEs," says Scott. "Staff are doing more with less, and without sacrificing quality."

Multi-generational training

"People are working later in life today, for myriad reasons. In just a few years, most companies will be employing five different generations," says Scott.

"One-size-fits-all" training isn't enough anymore for today's patient access departments, she argues. "Without understanding how each generation learns and what motivates them, you cannot form a viable training program," warns Scott. "Ultimately, you will increase your turnover rate."

Scott says the vast majority of her Generation X team members prefer hands-on "social learning" over attending lectures, while most baby boomers want some traditional classroom training before they perform a given task.

"Once they feel comfortable, they want to be left alone to do their work," she says. "However, the nature of our industry is constantly changing. The baby boomers are adapting to 'social learning' more as time goes by."

Scott includes more than one approach in her training, to appeal to different learning preferences. The 12-day program is taught by full-time training specialists at BayCare's Central Business Office and covers insurance, compliance, patient satisfaction, documentation, cash collections, and scripting. "Staff do not just sit and listen to instructors. They role play, practice 'live' registration, and play games involving compliance issues," Scott says.

Next, each team member is paired with a more experienced employee who can help with complicated registrations such as trauma patients and also guide them through "'off-the-wall' scenarios that don't happen every single day, she says. "It may not be an extremely common case, but it does happen," Scott says. "It is easy to forget the process to handle them."

For example, a new team member probably would need guidance registering a 65-year-old man who was hurt driving a company vehicle, with both managed care insurance through his employer and Medicare coverage. "Once team members feel ready to be on their own, they are then set free," says Scott. "It does not stop there, either. Each team member's work, regardless of tenure, is quality-checked every day."

More multitasking

Even the most talented patient access employee struggles with new skills at times, says Cynthia Norman-Bey, director of patient access services and the PBX (private branch exchange) Call Center at Glendale (CA) Adventist Medical Center.

Norman-Bey has seen experienced registrars find it difficult to protect the hospital's bottom line by ensuring that cash collections occur appropriately, while at the same time respecting the fact that a particular patient is struggling financially, for example. (See related stories on how to train staff on new skill sets required in patient access, p. 75, and evaluating why an employee is struggling, p. 75.)

Here are strategies Norman-Bey uses to individualize training for patient access staff:

• During weekly quality assurance meetings, patient access supervisors review the performance of staff, with a particular emphasis on customer service.

If Norman-Bey thinks there is a need to have more than one meeting a week regarding a particular employee's performance, then one-on-one mentoring is provided. "Service excellence then becomes the norm," she says. "I believe that providing a mentor to staff is the best, least costly, and most effective training."

• Individualized training is developed by supervisors, based on daily quality assessments conducted for each employee in the department.

"Our department is a high-level call center that provides a multitude of services for both internal and external customers," adds Norman-Bey.

Staff members look at actual scenarios of the best service provided in the department and the "not-so-good service," she says, and they identify what could have raised the bar to better service, she says.

• The department invested $1,500 in customer service training DVDs.

"We require our staff to view these on a monthly basis," Norman-Bey says. "We review and discuss the DVD at each monthly meeting, emphasizing key service points."


For more information on training patient access staff, contact:

• Luka Krietemeyer, Patient Access Services Manager, Patient Accounting and Access Center/Financial Clearance Center, OSF Healthcare System, Peoria, IL. Phone: (309) 683-9800. Fax: (309) 683-6793. Email:

• Cynthia Norman-Bey, Director of Patient Access Services/PBX Call Center, Glendale (CA) Adventist Medical Center. Phone: (818) 409-6686. Fax: (818) 545-1870. Email:

• Tammy A. Scott, CHAM, Patient Access Service Manager, Emergency Center, St. Joseph's Hospital, Tampa, FL. Phone: (813) 870-4065. Email: