Take patient access to the next level; revamp how you measure competency
Get in front of this 'emerging area'
The role of your patient access staff has undoubtedly changed dramatically and will continue to become more complex. It's likely, though, that the way you evaluate competencies doesn't reflect this evolution.
"The face of patient access is changing dramatically," says Jennifer Nichols, director of patient access at Spectrum Health in Grand Rapids, MI. "There was a point in time when access was primarily a welcoming function, with some data entry. The role has grown tremendously in the skill and expertise required."
For this reason, Spectrum Health's access department decided to change the way staff competency is evaluated. In doing that, managers used clinical competencies as a model.
While nurses must demonstrate they are able to perform a given procedure or they aren't allowed to do so, the same is not true for patient access.
"Nursing staff have annual competencies that they have to fulfill, to demonstrate and refresh their skills necessary to perform that job," Nichols says. "Following that analogy, we have expanded that to the patient access role."
The department struggled to find other institutions that had done something similar in their patient access departments. "It's been very difficult for us to find comparative data with comparable institutions doing this. There are some, but there are not many," Nichols says.
"A robust competency department seems to be very well accepted in the clinical world, but has not been extended to the non-clinical world, which is still part of the patient experience," Nichols adds. "This is an emerging area right now."
An Access Professional Competency Program was implemented at Spectrum Health in early 2010. A year prior, a facilitated session was held with representatives from all aspects of the revenue cycle.
"We asked them to identify the most important competencies for staff. Some themes started coming together," says Nichols. "One of those was the importance of understanding the linkages with the rest of the revenue cycle, and how the work staff do is intertwined with the entire patient experience."
Staff took online tests with more than 100 questions covering the entire revenue cycle. The test covers nine areas of assessment: compliance, teamwork, computer literacy, patient intake, medical terminology, coordination of benefits, patient balance determination and collection, revenue cycle concepts, and payer identification.
Staff are able to take the test from any work station, and are required to pass each of the nine assessments with a score of 80% or better. The vast majority of staff more than 90% passed all the assessments.
"This shows their level of dedication, with what I think could be challenging questions even for long-time hospital professionals," says Nichols. If staff don't pass a particular assessment, one makeup session is offered.
What would be done if staff do not pass the competencies? "We needed to think about disciplinary action," says Nichols. "What should our response be if staff can only address 70% of what we feel is essential regarding, for example, coordination of benefits? What are things that would be risks to successfully performing the job?"
In addition to getting a second chance to take exams that they didn't pass the first time, staff use guided review sessions and online resources to help them prepare. "Our expectation is that each assessment is passed. If you don't, we have competency concerns. We take actions, including corrective action," says Nichols.
Alternatives to tests
Managers intend to give the competencies annually. "But we don't just want to hand out the same exact questions," says Nichols. "With ever-changing payer requirements and the impact of health care reform, with all of these things coming down the pike, we need to keep it fresh and relevant for staff."
Going forward, staff may be offered other options to prove their competency. "We are considering adding more of a demonstrative aspect, another avenue beyond traditional test-taking, that staff can use to demonstrate proficiency," says Nichols.
For instance, staff may be able to present a project or idea that they successfully implemented in their department that demonstrates a specific competency.
The competency testing had "a two-pronged effect" on the department, says Nichols. "It's been a nice success story to share with hospital leadership to show the level of proficiency that our staff exhibit," says Nichols. "Secondly, it is a nice validation for staff."
After the questions were developed, they were shared with senior leadership within the revenue cycle.
"They really have a good appreciation for the challenges that can exist for these key, 'front-door' team members," says Nichols. "It was a nice showcase of the level of skill needed for what used to be considered as entry-level staff."
[For more information, contact:
Jennifer Nichols, Director, Patient Access, Spectrum Health, Grand Rapids, MI. Phone: (616) 308-4119. E-mail: [email protected].]
The role of your patient access staff has undoubtedly changed dramatically and will continue to become more complex. It's likely, though, that the way you evaluate competencies doesn't reflect this evolution.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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