Does a colleague question you constantly, undermine departmental goals, or just get on your nerves?
“One of the biggest challenges for today’s patient access managers is simply getting along with all of their coworkers,” says Valerie Macelis, BA, MBA, CHAA, a marketing representative at VITAS Healthcare in Norwalk, CT. Macelis is a former patient access trainer at Western Connecticut Health Network.
“We spend more time with our co-workers per day then we do with our own families,” Macelis says. “Values, ideas, and work ethic vary from person to person.”
Macelis recently worked with one particularly difficult colleague.
“She refused to listen to me, as a veteran employee, and questioned everything that I did,” she recalls. “She created problems with other co-workers.”
The employee complained to the department director about Macelis.
“The tension in the department made it very difficult for me to do my work properly and on time,” Macelis says. Other patient access employees were uncomfortable with the friction between their two colleagues.
“The advice I would give other patient access leaders who have to face something similar is to find a way to get along,” Macelis says. She suggests finding a common interest to make it easier to work together. If you are unable to do so, make management aware of the issue.
“They may be able to work things out, or move people around to make sure work is not uncomfortable for everyone involved,” Macelis notes.
Lauren Blanchard, MBA, interim director of patient access for Crozer-Keystone Health System in southeastern Pennsylvania, says patient access managers or supervisors should get involved right away if there’s tension between two co-workers. The first step is to have a meeting with both of them.
“Discuss what is and is not appropriate and make consequences clear if the behavior continues,” she says.
Blanchard says that simply walking around the department and being visible is an effective way to open communication about conflicts between colleagues. She also encourages employees to call or email with concerns with an open-door policy.
“Let employees know all of the different ways that they can report concerns so that they feel confident that they will be heard,” she says.
Blanchard says a confidential employee hotline also can help.
“This can handle concerns that need a mediator, or that cannot be addressed directly with the manager or supervisors in the department,” she says.
Here are some common examples of patient access employees who might be perceived as difficult, with strategies for each:
- Employees who constantly question leadership’s decisions.
Blanchard welcomes questions if they’re asked out of a genuine desire to improve.
“The problems arise when questions have been fully and clearly answered, but performance standards are still not being met,” Blanchard explains.
She recommends these steps:
- Find out if more education is needed. “Check the process. Is there something that was left out or unclear?” Blanchard says.
- Interview the employee directly. “Find out if there is something they want, or do not understand,” Blanchard recommends.
- Ensure employees communicate concerns directly to leaders. Blanchard encourages this by always following up promptly. “Do this even if the cause for concern proves to be unfounded,” she says. “This shows the patient access employee that management takes time to investigate things that are important to the staff.”
- Employees who question the productivity of their co-workers.
“I post productivity statistics on our community board so that all employees can see that they are productive as a team,” Blanchard says.
First, she asks the employee who is making the complaint why they believe their co-worker is not productive.
“I then run the reports. If there is no reason for the complaint, I let the employee know I reviewed the numbers again and they are correct,” Blanchard says.
- Employees who complain often, undermining departmental initiatives.
“This creates a toxic, negative atmosphere. It drives good employees away,” Blanchard warns. She recommends these steps:
- Make time to sit down with these employees and clarify expectations regarding professionalism. “Try to pinpoint what exactly is making them so unhappy,” Blanchard advises.
- Ask the employee what you can do to help them succeed.
- Create an action plan with a timeline.
- Document your conversation. “This will assist if the problem continues and corrective action must be taken,” Blanchard says. “Gossip and complaining must be dealt with on an individual level.”
- Employees who need everything explained multiple times.
Clear expectations — and consistent enforcement of standards — are two keys.
If a particular registrar still struggles after training, Blanchard says, “The employee should be re-assigned to a different area more suited to their abilities.”
- Lauren Blanchard, MBA, Interim Director of Patient Access, Crozer-Keystone Health System, Springfield, PA. Phone: (610) 447-6290. Fax: (610) 447-6993.
- Valerie Macelis, BA, MBA, CHAA, Marketing Representative, Vitas Healthcare, Norwalk, CT. Phone: (203) 805-1018. Email: [email protected].
Are Clinicians Really Rude, or Just Doing Their Jobs?
High-pressure situations may lead to misinterpretations of messages
A nurse rushes by a registrar on her way out of the treatment room without even making eye contact. A physician doesn’t even acknowledge the registrar in the room who’s obtaining demographic information. Are they being disrespectful, or just doing their jobs?
“Some clinicians viewed as difficult are merely driven and detail-oriented,” notes Lauren Blanchard, MBA.
ED nurses and physicians working in high-acuity, time-sensitive situations might appear rude when, in fact, they’re just doing what’s needed for the patient.
“If a trauma physician makes a demand and appears agitated or irate, it is often due to the critical nature of the patient,” Blanchard notes.
At times, if the registrar enters the patient’s information incorrectly or too slowly, it delays care.
“Harm could come to the patient,” Blanchard notes.
However, this doesn’t mean clinicians are allowed to be rude or inappropriate to registrars.
“To avoid these situations, create a culture of respect and responsibility between clinical and non-clinical staff,” Blanchard urges. She recommends patient access directors address concerns about rudeness by:
- meeting with clinical leaders about the issue at a later point in time.
“It’s better to have the discussion about proper behavior at such time when patient safety will not be affected,” Blanchard says.
- encouraging registrars to speak up if they feel they’re being disrespected.
Blanchard encourages registrars to use this format: “I felt (emotion) when (what happened) because (reason).”
For instance, “I felt disrespected when you demanded I update the patient’s information, because you yelled across the room and other patients and staff members could hear everything you said.” Or: “I felt confused when you told me to go to lunch right away, because another employee came in earlier than I did and had not gone to lunch yet.”
“This allows the employee to calmly convey what they felt, what triggered the reaction, and why, without accusing the other employee of any wrongdoing,” Blanchard explains.
- creating a workflow for handling concerns in a private and timely fashion.
Blanchard responds to concerns within 24 hours to show she received the complaint. She provides a date as to when the employee can expect to hear back. “I usually offer follow-up within a week of the initial communication, regardless of whether there has been a resolution,” Blanchard says.
- providing follow-up to the employee who brought up the concern, even if the cause for concern proves to be unfounded.
This shows the patient access employee that management takes time to investigate things that are important to the staff.
“By being diligent in providing two-way feedback, behaviors such as gossiping, complaining, and questioning leadership are greatly reduced,” Blanchard says.
