A registrar in the outpatient rehab clinic at Ochsner Healthcare’s Northshore Region always notes if a particular patient is scheduled, who is someone that she knows has difficulty walking. A few minutes before the patient’s appointment, the registrar leaves her station.
“She goes to the parking lot to see if the patient has arrived,” says Tanya Powell, CHAM, patient access director of the Slidell, LA-based facility. “She walks outside to help the patient in.”
Powell encourages her staff to use simple acts of kindness and respect to create a “red carpet experience” right from the moment patients arrive. “If our team is fumbling, we allow uncertainty or lack of confidence to creep into the picture,” says Powell. “We have to have the ‘wow’ factor from start to finish.”
A registrar recently was approached by an elderly man with a cane looking for a senior safety driving class, with a phone number and address written on a piece of paper. “I tried calling the number, but it went to voice mail. We knew the address was wrong,” says Powell. Meanwhile, a registrar Googled the phone number and found the correct address.
Powell walked the man to his car, after giving directions. “His wife said this was the fifth place he had gone into to ask for help,” she says. “It took us only a few minutes, but he had to go to four places before he found someone to help him.”
Another patient was on her way to a clinic for the first time and became lost. The patient’s daughter called and was very upset. “A registrar guided her through the area and stayed on the phone with her until she arrived at the clinic,” says Powell.
Patient access takes the following steps throughout the patient’s visit:
• At the time of arrival.
“At centralized registration, one registrar is designated to stand at the arrival desk to personally greet the patients,” says Powell.
• While the patient is waiting.
Registrars continually survey the lobby for any patient waiting over the 15-minute mark, so they can intervene.
• If the patient came to the wrong location.
Patient access staff members take two steps. First, they notify their counterparts at the correct location that the patient is on the way. “Next, staff walk outside to actually point to the accurate building for better wayfinding,” says Powell.
• During long waits in the ED.
ED registrars rush to the break room to obtain ice packs or blankets for patients, as needed. “Registrars donate clothes from home to share with patients in need and donate books to help entertain the children,” adds Powell.
Remove All Barriers
Patient access leaders at Boston Medical Center, with the Pensacola, FL-based healthcare performance firm Studer Group, recently launched a new patient satisfaction initiative. The department added new protocols, training, and metrics for “patient-facing” jobs.
Erika Gaudreau, RN, MBA, senior director of patient access, says, “This includes registrars in the clinics, ED, radiology, admitting, and other areas.” It also includes areas where staff members interact with patients by phone: call centers, managed care areas, and pre-registration.
A simple hello goes a long way when it comes to satisfying patients, says Gaudreau. Eye contact and friendly small talk help as well. If patient access managers notice that staff members are looking down at their computers or aren’t conversing with patients, “it is our job to understand the barrier and remove it,” says Gaudreau.
It might be that employees are too busy, have not had a break in some time, or generally feel overwhelmed with their jobs. “When giving feedback to registrars, managers first tell them what they did well, then we tell them how they can improve to meet benchmarks,” says Gaudreau.
Sometimes registrars are uncomfortable introducing themselves or think they don’t have time to do it. Managers point out that registrars have access to all kinds of information on patients, “and we can do them the courtesy of providing them with our name,” says Gaudreau.
Managers often roleplay to reinforce behaviors they want to see. “We ask the registrar to act as if we were a real patient and go through the steps,” says Gaudreau.
Powell reports, “For my region, we have been maintaining successful scores above our established goals of 60% ranking since 2015.” She credits the department’s success with these items:
• Patient satisfaction is a constant topic of discussion.
“This includes emails, daily huddles during rounding with staff, and staff meetings,” says Powell.
• Patient access managers continually observe the way registrars interact with patients.
“Our leadership is on the frontline, coaching our team through witnessed patient encounters,” says Powell.
• Results, including metrics, outcomes, and survey comments, are shared with all patient access employees.
“If an area falls below the metric, managers step up their observation efforts to find out why,” says Powell. (See related stories later in this issue about how departments can fix patient dissatisfiers and how to identify registrars’ concerns.)
SOURCES
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Tanya Powell, CHAM, Patient Access Director –Northshore Region, Ochsner Healthcare, Slidell, LA. Email: [email protected].
