An employee might be detail-oriented, friendly, with an encyclopedic knowledge of payer requirements. An emergency department (ED) registrar, however, also has to be comfortable working in a setting where they’ll encounter tragedies, suicidal patients, and gunshot wounds. Here are two ways patient access leaders can determine if someone is a good fit for the ED:
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Describe the ED environment in detail.
Michael F. Sythe, director of revenue cycle operations at Eisenhower Medical Center, shares these details about the reality of working in the ED setting with applicants:
— The ED is a fast-paced environment.
— The ED is a very close working space, with clinicians working alongside registrars.
— The ED is stressful at times due to an often-full waiting room and lengthy waits to be seen.
— Bad outcomes, including death, occur with family members present.
Sythe also describes the sights, sounds, and smells that occur. “Some people have a very low tolerance for the smell of vomit or neglected hygiene,” he notes. “In the case of an auto accident, there may be blood, missing limbs, scrapes, bruises, and such.”
Sythe notes that the registrar will be in close proximity to homeless individuals, psychiatric patients who are a threat to themselves or others, crime victims, perpetrators of crime, and drunken drivers, and he carefully observes the applicant’s reaction. “If they have a look of shock on their face, they might not be a good fit in the ER,” he says.
Some applicants confide that as parents of small children, they don’t feel they could handle working in the ED. “I appreciate their honesty,” he says. “That doesn’t mean they won’t be a good fit elsewhere on the patient access team.”
Sythe finds that nursing students typically are a great match for the ED. “They might not have the patient access experience, but they really have the drive to be in that specific area,” he says.
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Have applicants shadow in the ED.
Lolita M. Tyree, CHAM, MSW, patient access manager in the ED at Riverside Regional Medical Center in Newport News, VA, has candidates “shadow” registrars in the department for several hours after she interviews them.
“The likelihood that the candidate will experience something unusual is pretty good,” she says. “The current employees can see how they respond to situations and how well they interact with others.” Some candidates admit they cannot handle seeing blood or someone vomiting. One recently withdrew her application for the position after she realized it was not an office environment.
“This environment can be literally life-changing, so it is important to hire individuals that are able to deal well with pressure and can think quickly on their feet,” says Tyree. She looks for an ability to work independently and to work well under pressure.
During job interviews, applicants typically put their best foot forward. “They tend to relax when with peers,” says Tyree. “Peers notice behaviors that may not be displayed during the formal interviewing process.”
Co-workers sometimes tell Tyree that an applicant didn’t behave professionally. “They usually pick up if a potential candidate does not show any sense of urgency,” she adds. “This is key in an emergency room environment.”
