System’s ACE program helps existing employees
Session re-emphasizes skills
When the access services department at Providence Health System in Portland, OR, started its successful quality assurance (QA) and training team more than 2½ years ago, the goal was consistent training for new employees. With that accomplished, says regional quality assurance and training manager Jeanne Hughes, "we realized existing staff needed to hear the same things."
The result is Access Continuing Education (ACE), a daylong program designed to address the continuing needs of access employees. Using the ace from a deck of playing cards as part of its theme, the program draws on a variety of methods to make the day entertaining as well as informative, Hughes says. "It’s a great opportunity to have a day to step back and think about what they do and why they do it, and re-emphasize that."
Clearing up difficult topics
ACE is designed, she adds, to provide staff with the latest information on such topics as:
• customer service;
• compliance issues;
• form changes;
• insurance changes;
• ICD-9 codes;
• the Emergency Medical Treatment and Active Labor Act.
"We have pretty tough [to interpret] insurance cards in this area, with all the managed care and assignments to special groups," Hughes points out. "It’s tough to make sure you’re [identifying] the correct plan to bill." With the Emergency Medical Treatment and Active Labor Act, she adds, it’s important that all access staff, not just those in the emergency department, know the latest interpretations of the law. "We also review advance directives and conditions of admission."
Despite the sometimes serious subject matter, Hughes says, "it’s really a fun day for folks on the front line. They’re away from their duties for an entire day, lunch is provided, and we use a variety of formats and styles to keep it moving through the day. People just love coming to it."
It helps, she adds, that the sessions — held at least once and sometimes twice a month — are held away from the hospitals, at the office building where the system’s training facility is located. "It’s off-site for everyone, so no one is pulled out [to go back to work] no matter how busy things get. It’s really a commitment to training that we have."
Every registrar attends the session at some point in a 12-month period, Hughes says, and the time spent is a paid work day. "If it’s an on-call employee, this is an extra day for them; if it’s someone’s day off, we give them a different day off."
Different trainers from Hughes’ six-person QA and training department present different pieces of the program, she says, "just to break it up, so [participants] are not listening to the same person. The trainers all have their own unique styles. It’s also a good introduction to the entire training staff, so employees can put a face with the name of someone they e-mail questions to."
Four of the seven hospitals in the Providence system send staff to the ACE class, which gives employees a chance to interact with their colleagues at other facilities, Hughes notes. "One ED registrar might meet another from across town. It’s interesting and eye-opening and helps foster a sense of regionalization. The concerns are the same no matter where they are."
ACE trainers use catchy exercises and training tips to reinforce the points they’re making, she says. One of the ways to wrap up a session on, say, Medicare compliance, is to write the word "Medicare" down the left-hand column of a piece of paper, divide participants into teams, and have them write a related word or phrase next to each letter, Hughes adds. "You might put Medicare Secondary Payer’ next to the m’ or Advance Beneficiary Notice’ next to a.’ It gets them out of their seats and mixes everybody up, so they’re not with their partner from work."
Handouts also underscore the ACE lessons, she says. A sheet titled "What if I mess up (or find someone else’s mistake)?" outlines exactly what registrars should do if, for example, they find two medical records for the same patient or accidentally select the wrong patient or service type. Customer service handouts give pointers
on positive communication. (See illustrations, above and on p. 104.)
In January 2001, the second year of ACE will begin with a program that covers the same material but varies a bit in presentation, Hughes notes. "Every year will be a little different."
One aspect of ACE has a more personal slant for access employees, she says. Trainers explain Providence’s Career Paths program and talk about what registrars can do to move up to a
new position in the health system. "We talk about what we look for in a supervisor or in a QA training analyst when we have an opening," Hughes says, "so people have an idea of what they need to be doing to have a favorable chance at one of those positions."
Participants are told, for example, that showing leadership skills by volunteering to help coordinate a project like the system’s United Way campaign is one way to show off their skills, she adds. "The next time we have a position available, that favorable impression has already been made."
Because experienced access employees often look outside the department for advancement, Hughes notes, Providence has a goal of retaining its skilled employees and promoting from within. "We just had several manager positions open, and we had a manager at a smaller facility move up to a larger one, and a supervisor move to manager. Now there’s a supervisor position open."
Registrars who show skill at writing, training and analysis, she says, are likely candidates for the QA training jobs. "We tell registrars, If you find a problem and report it, be as detailed as you can.’ It’s a real opportunity for people to advance and it helps them to know the things they can do to promote themselves and to be prepared. Almost all of our QA and training analysts have come from being registrars or supervisors."
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