Be involved before switch to new ADT system

Before a new admission/discharge/transfer (ADT) system was implemented at Lee Memorial Health System in Fort Myers, FL, three patient access leaders were pulled from their previous jobs and worked full-time on the system implementation.

This group included Colleen Edwards, system director of registration and patient business services. "We need to be sitting at the table from the very beginning," she emphasizes. "Patient access can offer a tremendous amount of valuable information on patient flow and delays."

Before the new system was implemented, Edwards and other patient access leaders took these steps:

• They pointed out areas where steps could be taken out of the process.

While clinicians make the decision to change a patient's status from outpatient to inpatient, it was registrars who entered the information into the system, says Edwards.

"Changing the statuses of patients was always part of our function," she says. "We would get a call or report stating the status needed to change, and we would make the necessary change."

Patient access leaders pointed out that a step could be saved by giving case managers the ability to make the change to eliminate the step of calling someone else to tell them to do it, says Edwards.

• They cleared up misunderstandings about the role of patient access.

"Clinicians often don't understand what access is about. It can seem easy from a distance, but if you don't do it, you don't have any idea what it takes to get it done," Edwards says.

Identifying the correct patient is not always easy, she says. "With hyphenated names, name changes, and patients without social security numbers, just making the right selection can be a challenge," Edwards says. "And identifying the correct payer, with all the HMOs, PPOs, and networks, is a difficult task."

Patient access leaders took the opportunity to educate clinicians on all the information that registrars are required to give to patients and what it takes to accurately identify a patient, she says.

• They examined every patient access process.

An in-depth workflow was even performed on the process of scanning documents to ensure they can be easily found later, she says. "We learned that although it sounds good to be able to scan each document to its own document type versus document group, it is more time-consuming doing it this way," says Edwards. "And in the ED, every second counts."

• They considered the effect on revenue.

"We are responsible to ensure we can be paid for the services we are providing by identifying any available funding source," says Edwards. "That is one of our roles in the organization."

By looking at the entire process before the implementation, says Edwards, "people realized very quickly how much detail is involved just to get one bill paid."


For more information on patient access and system implementations, contact:

• Colleen Edwards, System Director, Registration and Patient Business Services/ADT Project Team Member, Lee Memorial Health System, Fort Myers, FL. Phone: (239) 424-3297. Email: