When staffing, don’t forget `other’ work
Staffing models don’t always factor in additional tasks performed by patient access, warns Stacy Calvaruso, CHAM, assistant vice president of patient access services at Ochsner Health System in New Orleans.
"Often we are the first call that is made when help is needed," she says. Patient access often are called upon for special projects such as outbound calls for special programs such as insurance company well visit scheduling plans, denial "clean-up" projects, or returned mail projects.
"We often call ourselves the IS, dietary, transport, maintenance, telephone and TV support desk, since we generally are the first folks that are called when someone has a problem," says Calvaruso. It is difficult to factor in these extra tasks when creating staffing models, she adds.
"A lot of it is done on a case-by-case basis," says Calvaruso. "Based on an educated guess, we determine staffing need. There is no magic formula."
Inventory extra tasks
At Kaleida Health in Buffalo, NY, several types of data are used to create staffing models: historical, projected, and trending volume; productivity; benchmarks; patient satisfaction; and provider satisfaction.
"A challenge in using productivity alone is to ensure that you have carefully considered and accounted for all of the other’ tasks that sometimes find their way to the registration desk," says Jen Nichols, senior director of revenue cycle operations. For example, registrars might enroll patients in patient portals or perform data collection.
Increasingly, registration completes additional work for the organization, says Diane Pazderski, RN, director of patient access services. Registrars field patient and provider calls, contact insurance companies, obtain authorizations and verifications, help with patient surveys, and more. "These are important elements of patient access, but they take time and resources," she notes.
Diligently inventory’
Patient access leaders must "diligently inventory" these tasks and carefully evaluate the most appropriate method and location to complete these, says Nichols. For example, in pre-registration, managers review historical call volumes and compare them to "scheduled" volumes. "We can identify the percentage of return calls and factor that volume into our staffing and benchmarks," says Pazderski.
Failing to include extra work can result in inadequate staffing and inaccurate data.
"There will be decline in staff morale when they are consistently unable to achieve the productivity target," Pazderski says.
