At Howard County General Hospital in Columbia, MD, the patient access department’s turnover rates remain too high, Carole L. Sraver, director of patient access, acknowledges. However, this rate is due to employees being terminated for failing to get to work on time or because they’ve failed to comply with a hospital requirement.
“We don’t have people leaving because they are unhappy with the department,” says Sraver. “In fact, we have people from other areas trying to get into our department.” Recently, two hospital employees moved to patient access from environmental services and dietary areas.
Here are some ways Sraver keeps morale high:
• Sraver posts “recognition boards” for coworkers to thank each other.
Coworkers thank their peers for helping a busy department, for covering shifts, or for giving them rides to work. “This allows the team to give a shout-out to their coworkers,” says Sraver. “These are also emailed to all staff on a monthly basis.”
• Sraver makes a point of including staff in meetings involving patient access processes.
Sraver always reminds employees that they’re the experts. “This inclusion allows them to know they are valued and their opinions matter,” she says.
• Sraver puts out a jigsaw puzzle for employees to do together during downtimes.
Once the puzzle is completed, it’s framed and hung in the conference room. “This allows everyone to see what can be accomplished with teamwork,” says Sraver.
• Sraver encourages staff members to air concerns.
Several registrars suggested having a hospital volunteer do the time-consuming job of scanning documents. “We tried it but could not get a volunteer to do this consistently,” says Sraver. The next recommendation was to have a designated time for scanning, with the off-going shift scanning documents during the half hour before the end of their shift.
“The 30-minute crossover in coverage allows enough time for any remaining documents to be scanned by the exiting shift,” says Sraver. “We have seen an improvement.”
Staff members also voiced frustration regarding obtaining Important Message from Medicare signatures. “The biggest issue was having time to obtain the patient’s signature, in addition to completing all of the registrations in the ED,” says Sraver.
The proposed solution was to have bed control staff members call the registrar working in the area of the emergency department where the patient is located. “They would then be responsible for obtaining the signature,” says Sraver.
Bed control staff members document the calls and to whom they spoke. “A report was developed that lets us track missing forms,” says Sraver. This report is reviewed by management regularly, to be sure that bed control has documented whom they called.
“We are then able to speak with the contacted individual to see why the form was not obtained,” says Sraver. “Other patient access staff are sent to the inpatient floors to obtain any missed forms.”
Personal Connection
Rosita S. Green, CHAM, director of patient access at Lanham, MD-based Doctors Community Hospital, has worked with thousands of employees in her 15 years in patient access. “I’ve collaborated with various executives to develop programs that helped organizations improve employee morale,” she says.
Over and over, Green has seen that good pay and benefits don’t necessarily mean good morale. “The employee’s rate of pay plays a part in staff morale. However, it is not the major deciding factor,” she says. “Relationships, teamwork, and recognition are far more important.”
Here are some ways Doctors Community Hospital’s patient access leaders get to know registrars on a personal level:
• Managers celebrate various types of achievements with gatherings at nail salons, spas, and restaurants.
Recently, the department celebrated exceeding its collection goal of $500,000. The outing was paid for with the patient access management team’s funds. Employees pay their own way at subsequent events, with managers getting group discounts online.
“These types of interactions build bonds,” says Green. “Employees then feel more comfortable when sharing and receiving business-related information.”
• Managers develop programs based on staff needs.
Recently, several employees expressed an interest in losing weight. “We developed a weight loss program. The goal was to lose the most weight in eight weeks,” says Green. Nineteen employees participated. “Employees encouraged each other to eat healthy and remain faithful to their exercise routine,” says Green.
The department’s “Who Wants to be a CHAA?” initiative provides tutoring assistance for those seeking to obtain the National Association of Healthcare Access Management’s certified healthcare access associate (CHAA) credential. “We have three employees participating in the upcoming training session,” says Green. “This prepares them for the next stages of their career development.”
• Managers ask patient access representatives to serve as subject matter experts at meetings.
An outpatient registrar recently conducted a weekend training session for ED registrars on how to properly identify and register outpatient infusion patients.
“During staff meetings, I often ask a staff member to facilitate the meeting or discuss an item on the agenda from their perspective,” says Green. (See related stories later in this issue on top morale-boosters and how to improve morale on a budget.)
SOURCES
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Rosita S. Green, CHAM, Director of Patient Access, Doctors Community Hospital, Lanham, MD. Email: [email protected].
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Carole L. Sraver, Director, Patient Access, Howard County General Hospital, Columbia, MD. Phone: (410) 740-7620. Email: [email protected].