At Miami-based Jackson Health System, daily huddles serve two purposes. Registrars receive updates on departmental changes, and leaders receive updates on what is going on with employees.
“Staff get to voice their ‘pain points,’” says Melissa Moreira, director of eligibility and patient access. Supervisors do more than just listen; they always follow up the next day on what action has been taken on the issue.
When staff first started working at home, the biggest complaint was lack of ability to scan or fax documents. Staff believed they could not perform their jobs without this capability. Managers quickly implemented an electronic faxing tool, and taught staff to upload documents directly into the medical record. The new process turned out to be easier. “Staff were much happier, as this saved them time,” Moreira reports.
The department is creating a virtual “Huddle Board.” This will include a mechanism for staff to write their proposed ideas, and for managers to answer them. “Staff really appreciate the feedback loop,” Moreira says.
Quick answers are not always possible. Some issues take longer to resolve because outside entities, such as insurance companies, are involved. “But since the item remains open, it’s a way for leadership to continue to pursue the issue until it is closed out,” Moreira notes.
To do something about what annoys staff, supervisors need to know about it. “As leaders, we have an obligation to not accept the status quo,” says Ralene Cosby, corporate patient access director at Brookwood Baptist Health in Birmingham, AL.
When walking through registration areas, patient access leaders continually ask the question, “Is there a better way?” These are some recent examples of how leaders fixed problems for staff:
• Preregistration staff used dual monitors, but they were of such small size that it was difficult to view the screens. Because of personnel changes in the organization, many widescreen monitors suddenly became available. “With no additional cost to the department, we were able to give each preregistrar at least one widescreen monitor,” Cosby reports.
• Some payers still require faxes for authorization requests, so staff wasted lots of time printing and faxing documents. “We inquired if IT had an electronic solution,” Cosby recalls.
It took just one phone call to find a solution. Patient access gave a list of contacts to IT, and IT loaded the information on each workstation. Something that caused endless frustration was surprisingly simple to fix. “It was a 10-minute task,” Cosby says. “This easy, no-cost solution had the added bonus of saving paper — at least a case a month — and toner expenses.”
• The analyst responsible for patient estimates reported that lack of access to information was causing inefficiency. The analyst was proficient in the Medicare Ambulatory Payment Classifications and the Blue Cross Enhanced Ambulatory Patient Group reimbursement system. “But there were often fee schedule-based rates that she had to refer to the contract team,” Cosby says.
The analyst wanted view-only access to this information, and IT found a way to provide it. “She could handle more accounts without assistance and felt more empowered in her role,” Cosby says.
• Staff were disappointed when Patient Access Week (which normally occurs in April) was canceled because of COVID-19. This event is something that all patient access departments and the centralized business office really look forward to, Cosby says. Leadership planned an event at the end of the summer to recognize the team’s hard work, with a “Golden Girls” theme. Registration areas were decorated, and door prizes were given daily for word games (scrambles and crossword puzzles). Lunch, snacks, and candy were offered.
The department had a small budget available to cover costs, but most of the expenses were paid by the leadership team. “The team was so appreciative, not only of the gifts received but also how much effort was put into the events,” Cosby says.
To do something about what annoys staff, supervisors need to know about it.
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