Pull staff from slow areas and save $190,000
Better results with less staffing
Executive Summary
Understaffing can decrease collections and increase wait times. By pulling staff from other patient access areas to cover hard-to-fill shifts, patient access leaders at Maury Regional Medical Center cut 5.6 full-time equivalents (FTEs) and saved $190,300.
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Ask registrars at other departments or facilities to work additional shifts.
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Give staff the option of asking someone else to work a holiday shift.
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Allow staff members to choose their days off.
Patient access leaders at Maury Regional Medical Center in Columbia, TN, saved about $190,300 in salary and benefits in 2013. Cross-training initiatives allowed for the reduction of 5.6 full-time equivalents (FTEs).
"Our volumes are up by approximately 10% over previous years, and our results for point-of-service collections, registration accuracy, and customer service are higher than they've ever been," reports Rodney Adams, MMHC, director of preservice and patient access. "We have reduced staffing, but we have better results."
By cross-training staff across all patient access areas, Adams is able to cover hard-to-fill shifts. "We frequently pull staff from one access point to cover another point, especially in times of high volume," he says. "Staff have been very open and engaged in this process and have really stepped up."
Tammy Casados, CHAM, patient access manager at St. Anthony Hospital in Lakewood, CO, has multiple registration areas to cover, including the emergency department (ED), surgery, the main lobby, the sleep lab, the wound clinic, the tranfusion/transitions clinic, the breast center, the imaging department, and pre-procedural testing. "Our challenges are when an associate calls out [sick] or an individual goes out on unexpected FMLA [Family and Medical Leave Act]," she says. "Understaffing puts hardship on our outpatient departments in meeting their pre-registration goals."
If registrars don't call patients ahead of time to verify demographics, this missed call adds time to the registration process when they check in. "This leads to complaints that our registration process is taking too long and holding up procedures," says Casados.
Understaffing makes it difficult to meet collection goals in the ED. "The registrar is keeping up with the demand of registering the patient, and this may be overlooked," says Casados. "If the patient doesn't stop at the discharge desk, the opportunity to collect is missed."
Fill open shifts
A lengthy hiring process makes it difficult for patient access to fill positions quickly. Once registrars give their two-week notice, Casados needs to obtain approval to fill the position. Only then can she start the interview process.
"It takes us six to eight weeks to fill a position," she says. "What I'm told from [Human Resources] is that the background check can take up to three weeks to complete."
Casados' goal is to hire 10 PRN positions to avoid being understaffed due to open positions. "We keep growing here, so our PRN positions usually end up taking a part-time or full-time position," she explains. Casados does the following to fill staffing gaps:
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She emails staff members to ask if anyone is interested.
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She contacts the sister hospital, St. Anthony's North, to see if any of the registrars wants to work an additional shift.
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She asks the ED unit secretary if she wants to work an extra shift in registration. "I work with the patient access financial counselor manager to see if she can spare someone to cover a registrar position in our ED or outpatient location," adds Casados. (See related story on giving staff more choices, below.)
SOURCES
- Rodney Adams, MMHC, Director, PreService and Patient Access, Maury Regional Medical Center, Columbia, TN. Phone: (931) 490-7103. Fax: (931) 490-3910. Email: [email protected].
- Tammy Casados, CHAM, Manager, Patient Access, St. Anthony Hospital, Lakewood, CO. Phone: (720) 321-0428. Fax: (720) 321-0430. Email: [email protected].
