Redesign improves admissions system

One-stop shopping for patients, payers

An admissions redesign at Marianjoy Rehabilitation Hospital and Clinics in Wheaton, IL has shaved off more than 150 steps in the admissions process and increased satisfaction among patients, payers, and referring hospitals, says Joan Bisterfeld, RRA, vice president of information technology and services, who facilitated the initiative.

The old system consisted of 187 steps and crossed more than five departments, she remembers. "It was time-consuming and very fragmented," she says. "For example, when family members called and asked for a direct admission, we had to refer them to their family physician, who then had to call us."

Referring hospitals and payers were also frustrated because they had to call around to five or six departments to complete the admissions process.

Now, all customers use an 800 number to reach an admissions team in a centralized department. Team members consist of an outreach admission representatives, admission representatives, and nurse liaisons.

Using a team approach builds accountability, she says. "Before, each person only had a little piece of the admissions process - and then they were out of the picture," Bisterfeld says. "In the new system, all admission employees are cross-trained to handle all functions from referral to the start of evaluation."

Five members of the admission staff work on site receiving basic patient information and processing financial verifications and precertifications. Six outreach admission representatives and nurse liaisons work in the field to collect admissions and medical information from referring hospitals, nursing homes, and physicians' offices. They also provide counseling to families and perform marketing functions such as conducting seminars and educational programs.

In addition to creating a single point of contact, the redesign reduced duplication of work. For example, under the old system, referrals were not being entered on-line as they were received, but rather listed on a paper form and then transcribed.

The hours of the admissions department were also expanded until 6 p.m. on the weekends and from 10 a.m. to 2 p.m. on Saturdays.

The four-week training program includes a mid-term, finals, and proficiency exam covering these topics:

· financial verification;

· available programs and services;

· use of the information system;

· admission procedures;

· marketing.

The staff also took field trips to Marianjoy's skilled nursing sites and role played various marketing strategies. "We wanted them to know how to talk to potential payers," she explains.