As volumes increased and wait times grew longer in the ED at Winston-Salem, NC-based Novant Health, patient satisfaction scores dipped.
“We tried communication with our patients, but the scores didn’t show huge improvement,” says Craig Pergrem, MBA, senior director of revenue cycle, pre-service, financial counseling, and onsite access.
The department decided to take a new approach by creating Compassion And Respect Everyday (CARE) cards. These cards list the three questions in the organizationwide Press Ganey survey that pertain to the ED visit. (Click here for the card.)
Elkin Pinamonti, MHA, assistant director of onsite access for Novant Health’s Greater Winston Salem and Northern Virginia markets, says registrars ask patients if they’ve met the expectations listed on the front of the card.
Registrars state, “Thank you, your registration is now complete. Do you feel that I was friendly and courteous? Do you feel that I have shown concern for your privacy when discussing your personal and insurance information? Do you feel that I made it easy for you in gathering this information?”
The department tracks the percentage of patients who give a “Top Box” score of 5 for every question. Pergrem reports, “We introduced the cards in our busiest ED and a medium-sized one last June, and saw immediate results.” Patient access discovered that patients really needed to know two things:
- That their registration was completed;
- That even if they were admitted to the hospital, all the signatures and paperwork needed for their admission already is in place.
“The comments patients made when we handed them the cards told us they were now understanding some things they hadn’t before,” Pergrem says. Patients commented, “I never knew my registration was complete.” Also, patients didn’t understand the difference between registration and the rest of their admissions experience.
Pinamonti says that giving patients the CARE cards “offers a nice segue into the more clinical aspects of the admissions process.”
By bringing the CARE card to the patient and saying, “Thank you. Your registration is now complete,” registrars bring closure to the process. However, that doesn’t mean the lines of communication are closed. Pergrem adds, “We let them know not to hesitate to ask us if they need anything at all prior to their leaving.”
Much-needed Morale Boost
Ninety percent of comments about the overall ED visit have been positive. All comments about individual registrars have been compliments. “This has been a great morale boost for the team members. As we all know, the ED is not an easy place to be,” Pergrem notes.
Since the CARE cards are returned directly to patient access managers, they can share the praise with team members right away, as opposed to waiting for organizationwide survey results to be shared. “It is often difficult to see the fruits of our labor without our own survey,” Pergrem says. “We felt this was a creative way to get around it.” Any registrar who has gone “above and beyond” receives a personal note of thanks.
By the end of 2016, the Top Box scores for the largest ED rose 8%, and overall, scores rose to the 88th percentile. A medium-sized ED saw Top Box scores increase by 5%, and finished with a 92nd percentile in overall scoring.
“The study showed it was worth trying the cards in the rest of the EDs, as well as our other registration areas, to see what kind of feedback we receive,” Pergrem says.
The CARE cards are part of an overall focus on the patient experience in the revenue cycle. “We have been able to lower our registration times below the five-minute mark,” Pergrem notes. “Our collections rose by over $7 million in 2016 as well, and our patients still like us.”
SOURCES
- Craig Pergrem, MBA, Senior Director, Revenue Cycle, Pre-Service, Financial Counseling and Onsite Access, Novant Health, Winston-Salem, NC. Phone: (336) 277-7249. Fax: (336) 277-0572. Email: [email protected].
- Elkin Pinamonti, MHA, Assistant Director, Onsite Access, Greater Winston-Salem, Northern Virginia Markets, Novant Health, Winston-Salem, NC. Phone: (336) 718-4935. Fax: (336) 277-8475. Email: [email protected].
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One health system made a small change in how it gauges patient satisfaction, which paid big dividends for all parties.
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