Access Management Quarterly: Report card provides staff feedback at a glance

Customer service, quality ratings included

A new registration report card at Children’s Health Care of Atlanta provides access managers with key information on the performance of individual employees in a convenient, easy-to-read format.

Much of the data was available before, but getting to it was a tedious process, says Millie Brown, director of patient access. The monthly report card, she adds, allows her to see, at a glance, how access employees are doing in five important categories.

One measurement given on the report card, she says, comes from information gleaned from the hospital’s Press Ganey Associates patient satisfaction surveys.

Although many hospitals are clients of the South Bend, IN-based firm, some may not be taking advantage of the opportunity to get back employee-specific reports on the data contained in surveys sent to Press Ganey, Brown notes.

Most hospitals look at performance by department, receiving results based on averaging the survey data, she adds. "So you get a score for the department, but you’re not able to get to the individual [performance]."

But Brown points out that "Press Ganey is able to [give back] any information we provide to them in a data file."

Feedback on employees

Even though the firm doesn’t need the patient account number that corresponds to each patient survey, she explains, Children’s Health Care includes that number, as well as the initials of the registrar whose service the survey reflects.

"That way, when we get back the data that are attached to the survey outcomes, we’re able to sort that data and compile [results] according to employee," she says.

Otherwise, Brown explains, unless a patient happened to mention the person in the survey, "you’d have to look it up — it would be lots of trouble" to get the feedback on an individual employee.

Depending on department, she notes, there are three or four survey questions that relate directly to the employee’s performance: "What was the wait time to register? Was the registrar friendly and courteous? Was the environment pleasant and clean?"

"I want to reward consistent behavior," Brown says, and not focus on an isolated positive report on a particular employee. "I might have a registrar who got five surveys back, with one glowing report and five bad ones. I want to acknowledge that you did [a good job] this time, but reward that you do it all the time."

With the individual data she has been obtaining through Press Ganey for more than a year, Brown says she has been able to look at an employee’s performance during that time frame. What just came together in April 2004, she adds, is the electronic process that takes that data, organizes it, and presents it in the neat monthly package that she has dubbed the registration "report card."

In addition to the Press Ganey customer service information, Brown explains, the report card includes four other measures:

1. Quality.

This figure is the result of random quality checks of registrations throughout the month. Registrars are expected to have an accuracy rate of 90% or greater.

2. Denials.

The number and the dollar amount of claims that are denied due to errors the registrar could have corrected are included.

3. Productivity.

This measurement reflects the number of registrations completed by the registrar. Depending on volume and area, the goals are based on each registrar doing his or her share.

4. POS collections.

This figure is the amount of money the registrar is responsible for collecting at the point of service.

"This is the first month we’ve had the report card completed like we want it," reports Brown, adding that she worked closely with the hospital’s information systems and technology (IST) department to develop the process.

"We worked with them throughout it. They were excited to do it," she explains.

In addition to the individual report cards, Brown explains, she receives one with the registrars’ results combined according to who their supervisor is, and one that organizes the results by manager.

Scores from the report cards are used for training purposes, for identifying top performers, and are rolled into employees’ annual job evaluations, Brown says.

The report cards also will be used to help determine winners in the department’s annual "Patient Access Awards," styled after the Academy Awards, which are presented in a ceremony held in October, just after the end of the organization’s fiscal year, she adds.

"We give awards to everyone who meets the criteria in all the given categories," Brown says. "There is a goal for each category — top POS collections, lowest denial rate, etc. — and we rate each employee with a 1, 2, 3, or 4," depending on whether he or she simply "meets expectations" or attains a higher mark.

Patient access awards go to the registrar who is at the top of each category and to the top overall performer, Brown adds. "There are also other awards, like gold medals for those who score over 95% in quality.

"The award ceremony last year was awesome," she notes. "The staff loved it, and my vice president said it was the best staff meeting he had ever seen, because everybody came back to work so motivated to do more."

Rewards increase motivation

The top performer received a surround-sound stereo system, Brown says, which she paid for with the funds usually spent doling out small rewards throughout the year.

"When she saw she had won [the stereo], that was it," she adds. "Everybody is determined to win next time."

While Brown’s access staff at Children’s totals about 150 people, she says the number of employees participating in the awards ceremony will grow to between 220 and 300 next year when it expands systemwide to include two hospitals and numerous satellite clinics.

At that point, Brown says, individual awards will be given by hospital, but there will still be one overall winner.

The wizard that appears at the top of the report card is the department’s training mascot, she points out. "He’s on everything that we do in that area, which makes the item instantly recognizable as having to do with training."

On Halloween, Brown and the training manager dress as wizards, and employees have to correctly answer a training-related question to get candy, she adds. "We have fun with it."