Long waits equal complaints, but reg times aren’t to blame

Patient access managers at Edward Hospital & Health Services and Elmhurst Memorial Healthcare in Naperville, IL, were hearing complaints from patients about long wait times in registration areas. However, registrars weren’t taking too long with patients.

“What was happening was that folks were walking into the area and having a seat, but not letting us know they were there,” says Miguel Vigo IV, revenue cycle system director of the Patient Access & Pre-Service Center. Instead, patients would simply show up, have a seat, and wait to be called.

“Registration folks are typically sitting behind a very large, ominous desk, with a computer screen between them and the patient,” notes Vigo. Some patients thought they were pre-registered and simply showed up at their appointment time. “If they had a 10 a.m. appointment, they thought somebody would come out and say their name because they are looking for someone with a 10 a.m. appointment,” says Vigo. “Patients didn’t realize we need to check them in before that happens.” Other patients tried to check in at the hospital’s information area, which is close to the registration area.

The department created a patient liaison role, which is taken on by a registrar on every shift in every registration area. “Their job that day, in addition to registering patients, is to go through the area at least once every 30 minutes,” says Vigo. Here are some of the things the patient liaison does:

• They give directions to the restroom, cafeteria, ATM, emergency department, or doctor’s offices.

Diane Tedeschi, lead patient service representative in the Patient Access Department at Edward Heart Hospital in Naperville, says, “Many times, we encounter lost people in our hallways. We have learned to recognize the ‘lost look’ and always ask if we can assist. The look of relief on the person’s face is immeasurable.”

• Sometimes the liaisons call doctors’ offices to confirm the patient has an appointment and to let the office know they are on their way.

“We are also detectives. Many times, patients don’t know if they are seeing a doctor or having a test. We figure out where the patient should be,” says Tedeschi. This step reduces unnecessary lines at registration caused by patients in need of directions, instructions, or updates.

• The patient liaison makes sure magazines are neatly arranged, that any items left by patients are removed, and that childrens’ coloring areas are stocked with coloring sheets and crayons.

• The liaison asks all those who are waiting if they need water, a magazine, or a blanket.

“Patients know they aren’t forgotten and get a little bit of our ‘welcome touch,’” says Vigo.

Some patients arrive very early for diagnostic tests and become more anxious during the long wait, or family members become visibly anxious while waiting for a test to be completed. “Some additional attention reassures them they have not been forgotten,” says Tedeschi. “We give them a timeframe for how much longer it will be.”

• They greet all patients.

The department has a “10-foot, 30-second rule.” “If someone walks into our area, even if they do not approach the desk, if they come within 10 feet of us or remain in our department for 30 seconds, then we greet them,” says Vigo.

Registrars use this scripting: “Good morning. Thanks for coming to Edward/Elmhurst. How can I be of assistance to you today?”

“Usually, that will tell us why they are there,” Vigo says. Sometimes the registrar finds out the patient is in the wrong place. A patient easily can get mixed up with instructions such as “Your appointment is at 10 a.m. Arrive at 9:45 a.m., park in the South Parking Lot, and go to the South lobby registration area.”

“If it requires the patient moving, we don’t just say, ‘Go down this hallway, make a right, and then make a left.’ We walk them to wherever they are going,” says Vigo. Registrars then clearly explain to the person in that area what the patient needs, so the patients don’t have to repeat themselves again.

Staff members end the encounter by saying, “I hope you have a good day. If there’s anything else that you need, my name is _______, and I work in registration. Feel free to reach out to me if you need anything else.”

“We always give our name and let them know where they can find us,” says Vigo.

Patients located for techs

Some patients register, but then leave the area to go have coffee or go to the restroom. “They would miss their name being called and would then have to wait an additional 20 or 30 minutes or longer,” says Vigo.

When patients are checked in, an order requisition alerts the clinical team that the patient is ready to be seen. The technician then comes and calls the person’s name. If no one answers, the patient liaison helps the technician locate the patient or says, “You know, we just registered them, but I don’t see them in the area. Maybe you should come back in a few minutes.”

If nobody responds the second time, the technician goes to the main check-in desk and asks about the patient. “We tell the tech to keep the order out,” says Vigo. “When rounding, 90% of the time we will connect with the patient and put them back in contact with the department.”

Even on days when registrars aren’t assigned the patient liaison role, they’re expected to keep a close eye on everyone waiting in the area.

“The idea is that all of them are filling that role, maybe just not with that title on that particular day,” says Vigo.

SOURCES

• Diane Tedeschi, Patient Access, Edward Heart Hospital, Naperville, IL. Phone: (630) 527-3626. Email: [email protected].
• Miguel Vigo IV, Revenue Cycle System Director, Patient Access & Pre-Service Center, Edward–Elmhurst Healthcare, Naperville, IL. Phone: (331) 221-3413. Email: [email protected].