Access Feedback: What’s in a name? Losing Access’
Most say access’ is not precise enough
The question posed in the March issue of Hospital Access Management regarding the viability of "patient access services" as the name for those departments that, among other things, handle admitting and patient registration, drew more response from readers than any previous issue addressed in this column.
Jack Duffy, FHFMA, director and founder of Integrated Revenue Management in Carlsbad, CA, and a veteran administrator in the access field, suggested in that issue that there might be a trend toward going back to names such as "admitting" and "registration" for those departments.
Most of the HAM readers who had called or e-mailed by press time said they would welcome a return to the traditional nomenclature.
Kathy Pope, regional director for admitting at Christus Schumpert Health System in Shreveport, LA, says, "’Hospital access’ is too vague a term. Call it what it is." Pope said her facility’s administrators chose not to change her department’s name despite the industry push to do so. "Our concern was that patients would not understand where to find admissions/registration if the name was changed to Hospital Access Department.’"
"That is probably one of the reasons that the name change has not been as acceptable as medical records changing to health information services," she notes.
In the latter case, Pope adds, the department name and signage were changed accordingly at her facility.
Beth Ingram, CHAM, director of patient financial services at Touro Infirmary in New Orleans, says she believes there is a push in some areas of the country to return to the more traditional titles.
"For our facility, and several I was in while doing consulting, the focus is on having departments named something that patients can relate to," she adds. The idea, Ingram says, is for patients to "easily identify from signage where to go to have their needs met."
Julie Harris, CHAM, director of admissions and health care information management at Mt. Graham Community Hospital in Safford, AZ, says her hospital did not change the admitting department’s name to "access" because of possible confusion with a government program. "Arizona’s Medicaid program has the same name — AHCCCS," she adds.
While hospital administrators are fine with calling the department "admitting" or "admissions," Harris says she would prefer something else. "I don’t have any other names in mind. Hopefully, someone will come up with a great name that our administration would prefer to admitting.’"
Connie Haynes, admitting supervisor at Estes Park (CO) Medical Center, also asked to go on record as being in favor of "going back to registration’ or admitting.’ We never have really called it that," she adds. "No one cared for it."
Linda Southard, regional manager for patient registration for Asante Health Care in Medford, OR, says there was a lot of discussion in 2000 among the upper-level executives of her health care group regarding changing the name of the registration department.
"One of our executives wanted to use patient access’ and the other did not," Southard adds. "I, as the regional manager, wanted to keep the name patient registration.’ Finally, after much discussion, we did not change the name because we felt our patients would not know what patient access’ meant."
However, Peter A. Kraus, CHAM, business analyst for patient accounts services at Emory University Hospital in Atlanta, says he does not have the sense that the access name is becoming passé. "My take is that it remains the best overall description of the front end of health care," he says.
"I’ve always felt that access’ complements, not displaces, traditional names such as admissions’ and patient registration,’" Kraus adds. "The NAHAM [National Association of Healthcare Access Management] Continuum illustrates how admissions and registration are subsets of access. In my opinion, the more specific term admissions’ is entirely appropriate when applied to admitting functions within the broad perspective of access.
"Bear in mind," he continues, "that access’ applies not only to the wide scope of front-end functions, but also to the diverse responsibilities of many front-end managers and directors. It can serve to define and enhance the stature of the job, thereby helping to promote career advancement."
Getting parents’ consent can be access challenge
Jean Steinbrecker, admissions manager at Children’s Mercy Hospital in Kansas City, MO, is looking for suggestions on how best to obtain consents from the parents of her facility’s young patients.
"It’s mainly an inpatient concern," Steinbrecker explains. "We do a lot of direct admits, where the physicians call and make arrangements, and the patients bypass admissions and go to the nursing floor. The [nurses] notify admitting."
Sometimes parents accompany the patient, but if the patient comes by transport, they may not, she notes. "We struggle with getting the consent signed. The nurses don’t think it’s their responsibility. If they do try to get the parents to come to the admitting department, sometimes they don’t make it."
When admitting employees go up to the patient’s room, they may find the parents are there only in the evenings, Steinbrecker says. In some cases, admitters try to get telephone consents, she notes. "We have had a few cases in which no consent form was signed."
"It’s not a huge problem," she adds, "but it’s enough of one that I’d like it not to be there."
In response to the area’s large Hispanic population, Spanish-speaking staff are on site on weekends to pull reports on overnight admissions and try to obtain consents, Steinbrecker says. "Our weekend admissions are done by bed control staff, but they don’t go to the floor."
[Please send feedback on access issues to Lila Moore at [email protected] or call (520) 299-8730.]
Audio conferences target disasters, medical disclosure
Have you missed one of American Health Consultants’ (AHC) recent audio conferences? If so, two upcoming conference replays offer another opportunity to take advantage of excellent continuing education opportunities for your entire facility.
• Disaster Response at Ground Zero: How NYU Downtown Hospital Handled Mass Casualties With All Systems Down, originally held on Jan. 10, takes participants to the heart of the World Trade Center disaster on Sept. 11. Just a few blocks away from the crash site, NYU Downtown was cut off from crucial lifesaving supplies and power, even as hundreds of injured came through the ED doors. HazMat teams on the roof of the hospital had to vacuum all of the debris out of air ducts to maintain air quality and keep generators running. Physicians and nurses had to balance urgent care with proper documentation. Learn how to prepare your facility for the unthinkable. The replay will be available from 8:30 a.m. on Tuesday, April 16, to 5:30 p.m. on Wednesday, April 17. Current AHC subscribers pay $249, which includes free CME and CE credit. The cost is $299 for nonsubscribers.
On April 23 and 24, What to Say When Something Goes Wrong: Do the Right Thing When Trouble Strikes also will be available for replay. This successful audio conference covers the major fear factors clinicians experience when confronting issues of medical disclosure. Learn benefits for patient and provider, as well as the risks of litigation and how to avoid costly legal battles. Free CE for your entire facility is included in the $249 fee for AHC subscribers.
To register for either one of these replays, contact American Health Consultants’ customer service department at (800) 688-2421 or [email protected].
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