5-day access training promotes consistency
December 1, 2000 7 minutes read
5-day access training promotes consistency
Geisinger designed systemwide program
More than a year ago, a team at Geisinger Health System in Danville, PA, was asked to take a look at how scheduling and registration personnel were being trained. That request ultimately resulted in the creation of a new department in the division of system access services and a comprehensive education program encompassing about 900 access employees.
"The whole concept started fairly small," says Elizabeth Ackerman, MEd, who became director of the new system access education department in April 1999. But after the team reported on the different training methods being used for access employees in the various clinics, the main admissions area, centralized scheduling, and the access (call) center, it was given a new challenge, Ackerman says. "Based on key competencies, could we develop a central [education] program instead of everybody doing their own thing?"
The team came up with the basic training module topics that form the program today, she notes. They include teamwork, professional behavior, confidentiality, technological basics, effective communication, dealing with difficult patients, adapting to change, point-of-service scheduling, and application training.
Time for a refresher
Her department, Ackerman says, was formed to take those topics and develop a program to provide consistent access education throughout the system. She now oversees an assistant and five trainers, a group that is responsible not only for promulgating the information to new access hires, but for providing refresher courses to existing employees.
For new hires, the access education program is designed to follow a two-day employee orientation provided by the human resources department, Ackerman explains. The five-day access program includes two days of emphasis on the first nine modules, she adds, and three days of application training on Geisinger’s scheduling and registration software.
"The flow of the module topics is that we try to start with the things that are simple or very general that we can build upon as we go through the two days," says Lynn Schankweiler, CHAA, training specialist. "We start with teamwork, as they will be working with the group for the next five days and are expected to perform as team members when they report to their site."
Highlights of the information covered in some of the modules, she notes, include the following:
• Professional behavior.
Trainers emphasize the importance of professional behavior, the role it plays in any organization, and "that it does make a difference to our patients," Schankweiler says. "We talk about how important voice is, that [employees] should choose their words carefully, and how their appearance and the appearance of the work area impact the patient."
As part of this module, participants view a scenario, acted out by the instructors, portraying poor examples of attitude, body language, appearance, and tone of voice. Dress guidelines for key access personnel, as these employees are called, also are reviewed.
• Confidentiality.
"We make [employees] aware of the patient’s right to confidentiality and what that includes," she notes, "and we review the forms that need to be signed before medical record information can be released."
Also in the confidentiality discussion, Ackerman points out, "we talk about the fact that a lot of things at the front desk that should be [private] are not always kept that way. If I have files on a desk in front of me and someone sees those the files, [he or she] could notice those patients’ names." The point, she adds, is to "take a look around and notice your area."
• Technological basics.
In this module, trainers introduce employees to the Windows environment, teach them e-mail messaging, and explain Geisinger’s Infoweb, the organization’s internal Internet. Employees learn how to use Infoweb for telephone and departmental directories and other information.
• Effective communication.
This module, Schankweiler explains, is about communicating with patients, the importance of accurate phone messages, and how to give clear instructions and directions. "We identify that [staff] will have to talk to people of all ages," she says. "We tell them if they’re talking to an elderly person not to assume the person is hard of hearing and talk louder." Geisinger staff, she adds, are instructed to address all patients using the last name and "Miss," "Mr." or "Mrs." unless given permission to use first names.
With children, Ackerman says, staff should include them in the conversation. "Not doing so tends to leave them out and also creates an environment where the child does not pay attention and may run around the waiting room."
• Point of service.
The objective in this module is to have the participant understand what needs to be gathered from the patient at the point of service. "Some [employees] who have never dealt with insurance and don’t understand why we need all this information are coming into the access role," says Schankweiler. "We talk about the importance of capturing the address, how to load the address into the computer.
"We start off the module," she adds, "by talking about the revenue cycle, trying to give the access person the big picture. They see that what they gather during the registration process follows the patient all the way through the revenue cycle."
Trainers wrap up the session with the subject of cash collection, emphasizing the importance of collecting copayments when the office visit is complete, Schankweiler says.
"It’s not just the copay," Ackerman notes. "If we know there are uncovered services, [the employee] also attempts to collect those payments. We also ask them to look up the account and see if the patient has a balance due and to say, "Are you prepared to pay this today?"
• Scheduling.
In this module, participants learn the basic components of scheduling and are introduced to Geisinger’s scheduling model. "We tell them, It’s more complicated than you might think — it’s not just putting a person in a time slot,’" Schankweiler says.
Following a role play of a scheduling conversation, trainers review the referral authorization process and the scheduling model.
Also in this training module, the new employees are introduced to a concept of "advanced access" that Geisinger is pursuing. The idea, Schankweiler explains, is to promote patient satisfaction by making care more accessible. (Look for more on advanced access in the next issue of Hospital Access Management.)
Evaluation piece stressed
After completing the access training modules, the new employee goes through three days of computer training on Geisinger’s registration and scheduling systems, and then reports to the work site, Ackerman says. At that point, she explains, the department begins an extensive evaluation process that sets Geisinger’s educational program apart from those of most other health care organizations.
"The supervisor receives an evaluation on the new employee that tells how the person did on each different topic module, so the supervisor is prepared to work with the employee on any area that needs extra help," Ackerman says. "If the person is a really good team player, we want the supervisor to know coming in that this employee can be a morale booster."
The supervisor works with the new employee on site-specific training, she notes. The system trainers perform site-specific training only with access center employees, such as the nurses who answer the system’s help line, she adds.
Six weeks after the hire date, the system trainers talk to the new employees as well as to the supervisor of each new hire, she explains. "We ask, What areas has the employee been able to pick up? Which do they still need to pick up? What else would you like for them to have learned?’"
Within two months of hire, Ackerman says, the employee is expected to return to system access education for a two-day advanced insurance course. "We go into more detail," she adds. "And they have to pass a competency test."
At the end of the general orientation, she notes, employees can perform most duties related to insurance but might have to go to a supervisor or more experienced employee with some questions.
Although the two-day access education program was created for new employees, Ackerman’s department began getting requests to provide the training for all access staff. "When the new employees came back and talked about what they had learned, [existing staff members] realized they could use a refresher course or that certain things had changed."
Every access employee has now received that training or will complete it by March 2001, she says. At that point, the department will begin offering an annual program for existing access employees. "We’re now in the process of developing 2001 topics. The goal is to have a different program every year."
In addition to the formal training programs, each system trainer is responsible for overseeing the educational needs of certain sites throughout the health system, Ackerman says. "They communicate with [employees at] these sites via e-mail or telephone and go out to each site two or three times a year and do a full site visit. They observe staff and talk to them about issues that have come up."
Those issues might include new insurance or how to correctly complete a Medicare Secondary Payer questionnaire, she adds. "They could talk about whether the area has a professional appearance. Sometimes a new set of eyes, someone with an objective perspective, can see things you don’t notice if you’re looking at it all the time."
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content