What patient access staff members have to say — about insurance coverage, scheduling, wait times, or out-of-pocket costs — doesn’t always please patients. But sometimes the way the registrar conveys information makes all the difference.
“Patients coming to the ED, having surgery, here for a baby delivery, or here for testing are nervous and anxious,” says Angela Small, CRCR, ED patient access supervisor at CHI Health St. Elizabeth in Lincoln, NE. “We see people at vulnerable times in their lives.”
Many patient access departments, including Small’s, are using the Studer Group’s AIDET (Acknowledge, Introduce, Duration, Explain, and Thank) approach to improve communication. Small gives two examples of how registrars use AIDET:
• A patient is brought to the ED by ambulance and appears to be scared and upset.
Acknowledge: The registrar makes eye contact and smiles at the patient.
Introduce: “Hi, my name is Angie.”
Duration: “I am going to do your registration. It should take about 10 minutes.”
Explain: The registrar explains every consent, patient privacy regulations, and informs the patient if a copay needs to be collected.
Thank: “Thank you for choosing Saint Elizabeth’s. If you need anything during your stay, please let a staff person know. Or if you have questions about what we went over, my name is Angie. Please just let someone know you need me, and I will come back.”
• A person comes to the front desk in the ED and asks for a family member. The person looks distraught when the registrar doesn’t see the family member in the system.
Acknowledge: The registrar reassures the person that he or she will do everything possible to assist.
Introduce: “My name is Angie, and I will help you find your loved one.”
Duration: “I honestly do not know how long this will take, but we will take time for you.”
Explain: “I have the nurse checking to see if your loved one is coming to us.” The registrar follows up when the issue is solved. “Mr. Smith, your wife was taken to another hospital. I have printed out a map to assist you to get to where she is.”
Thank: “Thank you for your patience. I wish you well.”
Much Less Anxiety
At The Cooper Health System in Camden, NJ, ED registrars often encountered angry patients upset about long waits. Tracy Khalid, the manager of ED registration, says, “People often felt like they were forgotten in the waiting room.”
The registrar lays the foundation of the experience that the patient will receive during the visit, explains Khalid. The department made these changes:
• When explaining how long patients will wait, registrars give specific time increments.
“Even if they cannot commit to a specific time interval with the patient, they can commit to a time when the patient will receive the next update from them,” says Khalid.
Registrars stay in constant contact with clinical staff. “They will oftentimes ask when a bed is expected to be cleaned or a patient transferred, to free up a bed,” says Khalid. The registrar passes on the expected timeframe to the patient.
• Registrars avoid statements that give a negative impression of the department, such as “We’re very short-staffed.”
“There is to be no finger-pointing ever,” says Khalid. “The registrar is to reiterate that our clinical staff is excellent and they are in good hands.”
• Registrars tell patients not to hesitate to come back up to the registration area if they feel worse.
“They can speak with the ‘quick look nurse,’” says Khalid.
• Registrars ask if the patients need anything to make them more comfortable, such as a warm blanket.
• Registrars come back to tell the patient if anything changes, such as several trauma patients arriving at the same time.
“The registrar explains that the clinical staff was called to assist in an emergent situation and that the patient will be assessed as soon as possible,” says Khalid. The registrar tells the patient that he or she will provide an update in 15 minutes and follows through on that commitment.
“These changes have decreased patient anxiety,” says Khalid. “Patients feel they are in good hands.” The department’s patient satisfaction scores also have increased. “There has been a 4% increase since the last quarter of 2015,” reports Khalid.
SOURCES
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Tracy Khalid, Manager, Emergency Department Registration, The Cooper Health System, Camden, NJ. Phone: (856) 342-2640.
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Angela Small, CRCR, Emergency Room Supervisor, Patient Access, CHI Health St. Elizabeth, Lincoln, NE. Email: [email protected].
