Executive Summary
When upgrading or integrating systems, patient access departments can avoid problems by documenting the department’s current workflow and performing multiple tests.
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Ask employees to identify potential glitches.
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Partner with vendors to provide effective training.
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Make sure patient labels print correctly.
“Test, test, test, and retest prior to going live” is the number one lesson learned after patient access systems were upgraded at Ann & Robert H. Lurie Children’s Hospital of Chicago, reports admitting director Robin Speaks, MSHSA, CHAM.
The department had several rounds of testing to make sure all applications and downstream systems were working as they should.
“When we experienced issues or concerns during the round of testing, we made sure the problems were solved before moving to the next round of testing,” says Speaks. Here are some examples:
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Online documents weren’t being categorized correctly.
“Our e-signature documents and paper documents were not moving to the correct category, once signed,” says Speaks. Instead of being stored as documents on file, they were being stored as “needed” or “expired” documents.
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Patient labels weren’t printing correctly.
“We tested printing labels, along with bar codes and face sheets. Everything printed as it should,” says Speaks. “However, we encountered problems when we went live.”
The enterprise number printed on the patient label, instead of the medical record number. “It was a quick fix,” says Speaks. “One piece of advice is to recheck system settings prior to going live.”
Patient access leaders at Temple University Hospital in Philadelphia recently upgraded the electronic bed management system.
“Unfortunately, after the upgrade, we experienced significant delays in the overall system response time and numerous downtimes due to server issues,” says Lisa A. Daly, MHA, director of patient access. Staff members had to revert to manual processes because critical information was dropping off of patient worklists, for example.
“The nuances of a new system affect the current workflow, the overall revenue cycle, and last, but not least, the claim,” says Daly.
Taking time to document your current workflow can head off some problems. “If you know how the system upgrade will affect your process flow, you can develop appropriate responses to avoid pitfalls,” Daly explains.
Managers might think they know exactly how a certain process is carried out. “However, things sometimes change over the years,” says Daly. “For example, instead of receiving paper documents, you now may be receiving phone calls instead.”
She found the following items helpful during a recent systems upgrade:
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Daly obtained employee buy-in by asking for input during frequent meetings leading up to the upgrade.
“Change is often times difficult for staff that have been using a system for a long period of time,” Daly notes. “Staff possess significant knowledge about both the process and tools.”
The bed management staff pointed out problems with the new system’s screens. “It just would not work in our environment and would have negatively impacted the overall bed assignment workflow,” says Daly. “We were able to make some adjustments prior to go-live.”
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Daly ensured adequate training of staff.
“Partner with the vendor to provide the most efficient and effective training,” recommends Daly.
Daly says if she had to do it over again, she would have conducted a mock simulation. “It would have been a great opportunity for us to test a real patient scenario, to make sure we did not overlook anything,” she says.
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Robin Speaks, MSHSA, CHAM, Director, Admitting, Ann & Robert H. Lurie Children’s Hospital of Chicago. Phone: (312) 227-1231. Email: [email protected].
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Lisa A. Daly, MHA, Director, Patient Access Department, Temple University Hospital, Philadelphia, PA. Phone: (215) 707-3438. Email: [email protected].
