EXECUTIVE SUMMARY
Patient access leaders are increasing patient satisfaction by setting positive expectations for clinical areas, including customer service in performance evaluations, and identifying the root cause of poor satisfaction scores.
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Closely track metrics that aren’t covered by surveys, such as abandoned call rates.
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Observe whether registrars are smiling, making eye contact, and saying “thank you.”
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Complete An Action Plan With Measurable Goals .
When patient access leaders at Charlotte, NC-based Carolinas HealthCare System created a new customer service training class, they decided to call it “First Face, Last Face.”
This title reflects the important role patient access is now playing in organization-wide customer service initiatives, says Chris Kiser, vice president of patient financial services.
“We chose the title because patient access is most often the first face the patient sees when they arrive and the last face they see before they leave,” Kiser explains. The class is not just for new hires. It’s required for every patient access employee. “All of our teammates have to go through an annual refresher course to ensure they maintain their customer service focus,” says Kiser.
The department has an internal training team of two FTEs who provide continuing and new hire education. “The training focuses on using key words at key times, and effective communication skills, to ensure patients all receive a consistent experience,” says Kiser.
Patient access employees are taught to use positive communication, focusing on solutions instead of problems. For example, instead of saying, “I can’t tell you how long the wait time will be,” registrars say, “I can assure you we’re making every effort to minimize your wait.”
The patient’s registration experience “sets the tone for the visit,” according to Jon Neikirk, executive director of revenue cycle at Froedtert Health in Milwaukee, WI. If there are problems with one aspect of the patient’s experience, such as registration, overall satisfaction scores tend to dip, he says. (For more information on this topic, see “Want satisfaction scores to soar? Simple solutions give big results", Hospital Access Management, July 2015.) Neikirk credits the department’s consistently high satisfaction scores to the AIDET model (Acknowledge, Introduce, Duration, Explain, Thank). (For more information on this topic, see “Set your criteria for customer service,” Hospital Access Management, August 2014.)
“To roll out and hardwire this throughout the organization required some internal resources,” he acknowledges. “But beyond that, it doesn’t cost us anything.”
Here are some other approaches that patient access departments use to increase patient satisfaction:
• Encourage registrars to praise clinical areas.
“From a registration standpoint, one reason we might have to apologize to patients is delays that aren’t the fault of registrars,” Neikirk says. Registrars resist the urge to go on the defensive and, instead, compliment providers.
A registrar might say to a patient, for example, “You’re in great hands with Dr. Smith,” or “I’ve been a registrar with the organization for the last five years. Just so you know, Dr. Jones is one of our best physicians. I always hear great things about him from our patients. He’s running a few minutes behind today, but he’s going to take great care of you.”
If clinics are backed up, registrars sometimes offer patients a coupon for a free cup of coffee in the hospital’s café. Some have even been known to walk out with a plate of cookies to offer patients. “If we keep staff engaged and empowered, they know what the right thing is to do for patients,” says Neikirk.
• Include customer service in patient access job descriptions.
Neikirk has found that including this wording is an effective way to hold patient access staff accountable for providing excellent service.
“Every line item in the job description ends up being an evaluation item on their performance evaluation, which affects their merit increase,” he explains.
To rate staff on customer service, leaders observe staff members. “This could lead to some behavior that they might not otherwise display,” Neikirk acknowledges. “We do try to do it nonchalantly, in the background.” Secret shoppers also are used. Employees from the hospital’s performance excellence department sit near the check-in desk and take notes on how staff interact with patients. They look specifically for smiling, making eye contact, and saying “thank you.”
Neikirk uses role-playing exercises so employees can practice these skills. Patient access managers ask staff to pretend they’re registering a new patient, or pretend that they’re telling an established patient that the clinic is experiencing delays today.
Corrective action is sometimes necessary. “If we have someone in the wrong role, we deal with that,” says Neikirk. “But more often, staff are rushed and don’t think through what they are saying.”
• Ask for feedback from peers.
“Happy staff lead to happy patients, so we work hard on staff engagement,” Neikirk says. “Staff also hold each other accountable.”
Managers encourage employees to let them know if a colleague is not treating patients according to the organization’s high customer service standards.
“We then do some additional observation,” says Neikirk. “If we do move down the corrective action path, leaders need to observe the employee firsthand.”
It’s often difficult for patient access managers to arrive at the root cause if patient satisfaction scores suddenly dip, says Wendy M. Roach, RDMS, CHAM, director of patient access at Advocate Good Shepherd Hospital in Barrington, IL.
“Therefore, we complete an action plan that storyboards our focus on patient satisfaction,” Roach says.
The action plan is a one-page document, separated into four sections. “This helps to clearly outline and define what the issue is and how we are working on it,” says Roach. Here is what the plan covers:
• What the reason for action is, and the target goal.
“Be specific and have goals that are measurable,” advises Roach.
A recent action plan involved satisfaction below the 90th percentile for three consecutive months in outpatient registration. The stated goal was to achieve satisfaction scores above the 90th percentile for three consecutive months in the areas of helpfulness, ease, and wait time. [The action plan used by the department is included with the online issue. For assistance accessing your online subscription, contact customer service at [email protected] or (800) 688-2421.]
• Anything that could be causing poor satisfaction.
Patient access managers list situations that could result in unhappy patients, such as construction within the main lobby or staffing shortages due to high turnover.
• Any analysis of any data that has been completed.
“One of our favorite activities is to read survey comments and create a chart analysis or a diagram based on the comments,” says Roach. (See related story on how to use satisfaction surveys, in this issue.) She creates a bar graph using an Excel spreadsheet and categorizes the concerns expressed by patients.
• What the department is working on.
This list includes any items that the department has worked on in the last week, what the department will work on in the next seven days, what the department is working on over the next 30 days, and any items for which the department will need leadership support. “This can be anything from computer hardware, tech support contacts, or even a recommendation for a department redesign,” says Roach.
SOURCES
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Chris Kiser, Vice President, Patient Financial Services, Carolinas HealthCare System, Charlotte, NC. Phone: (704) 512-4854.
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Jon Neikirk, Executive Director, Revenue Cycle, Froedtert Health, Menomonee Falls, WI. Email: [email protected].
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Wendy M. Roach, RDMS, CHAM, Director, Patient Access, Advocate Good Shepherd Hospital, Barrington, IL. Phone: (847) 842-4186. Fax: (847) 842-5325. Email: [email protected].
