Access Feedback
Maine hospital reports pre-reg consent success
In the July Hospital Access Management, Liz Kehrer, CHAM, manager of patient access at Centegra Health System, McHenry, IL, asked her access colleagues for feedback on how they get consent forms signed when the patient is preregistered for a service. "Where are the consent signatures being obtained?" Kehrer wanted to know. "Is the patient presenting at a quick check-in’ desk or going straight to the department where the service is being performed?"
And if patients are reporting directly to the treatment area, which is often being done to expedite the process, who collects those signatures?
In response to Kehrer’s query, Francis A. Wren Jr., CHAM, director of access management services at Eastern Maine Medical Center in Bangor, shared this description of how his facility handles the process. "We will preregister approximately 120,000 outpatients this fiscal year at Eastern Maine Medical Center," Wren wrote. "Patients report directly to clinical departments, where receptionists obtain signatures on consents and releases. Initially, we had everyone stop at the information desk on their way into the medical center, but departments warmed to the idea of obtaining the signatures themselves.
Managing patients’ flow
"Patient response has been wonderful," he continues. "In addition to our outbound preregistration calls to scheduled patients, many call our toll-free number when they are coming to the medical center for services. We give out preregistration wallet cards to all new patients, [encouraging them] to call ahead next time.
"For walk-in patients who bypass the registration areas and report directly to departments," Wren adds, "we have a courtesy phone linked to a preregistration employee for a registration interview. No one walks back to registration. We tube facesheets, consents, wristbands, cards, etc., directly to the clinical department. The departments obtain signatures. After treatment, the department returns the consents to registration and they are scanned into the electronic medical record. We hope to move to electronic tablets to eliminate this step."
In another response to Kehrer’s preregistration/consent query, Marne Bonomo, PhD, RN, regional director for patient access services at Aurora Healthcare in Milwaukee, says her department struggles with the same issue. "Most of our patients across a five-hospital region are either preregistered or go directly to their rooms upon admission," Bonomo writes. "One facility is [more than] 700 beds, so patients are really spread out. While we get all signatures from patients that check in through registration, we find it impossible to search out the preregistered patients on the units.
"Historically, when we did find the patient rooms, the patient was either busy with a clinician or out of the room for a diagnostic or therapeutic procedure," she adds. "The result is multiple missed attempts to secure a signature and uncounted man-hours taken away from registration. This becomes very expensive."
Patient care personnel currently handle this consent signature function, Bonomo notes, but want to hand it back to patient access. A recent survey has shown that many consents are falling through the cracks, she says, "a situation that is not acceptable."
Bonomo says she would love to hear comments and suggestions from HAM readers on this subject.
[Editor’s note: Francis A. Wren Jr. can be reached at (207) 973-8062 or via e-mail at [email protected]; Marne Bonomo can be reached at Marne_Bonomo@ aurora.org.]
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