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Observe staff: Are skills top-notch or lacking?
Since Pam Kast's office is part of the main admitting area in her hospital, she sees and hears her staff in action on a daily basis.
"I counsel staff on inappropriate patient encounters, and compliment pleasant ones," says Kast, manager of patient services for the admitting office and emergency department areas at Botsford Hospital in Farmington Hills, MI.
One patient was upset because she wrongly assumed an appointment would be at the hospital, when the physician's office had scheduled it at an off-site location, recalls Kast.
First, the registrar called the physician's office to see about relocating the test to the hospital. She then worked with the hospital's scheduling office, the testing department, and finally the insurance verification area to get the test scheduled and authorized.
"My registrar saved the patient a trip to an unknown location and the [frustration]of misunderstanding about the appointment," says Kast. "For this, I awarded her with Botsford bucks."
These come in $1, $2, $3, and $5 denominations, which staff use for purchases at the hospital's cafeteria, gift shop, and coffee shop, she says.
Kast rewards her employees for successful cash collection efforts in the ED, pitching in without complaint to help a coworker, getting things done or stepping in to help if a patient requires more help.
"This is often related to cash collection," she says. For example, if a patient is taken aback that a $25 copay is owed, sometimes just having someone else step in is enough to help the patient understand the requirement, she says.
"Even when I'm not around, my staff let me know when there's been a good assist," says Kast. For instance, staff may tell her, "Suzy Q helped get that collection," she says, or "Mr. Smith took out his wallet after she explained his coverage."
On another occasion, Kast heard a registrar say, after realizing that a patient failed to bring the physician's order for a test, "I will have to call the doctor to get his order." "My registrar's inflection caused the patient to apologize," says Kast. "Although she acknowledged, "'It happens; don't worry,' I knew she could have better handled the exchange."
Once the patient was on her way, Kast pulled the registrar aside to review the situation. "I asked how it could have been handled so the patient would not have felt the need to apologize," she says. "I suggested that the registrar could have said instead, 'Let me call the doctor's office to get a copy sent over,' or 'I'll just call the office for you, to get a copy of it.'"
Kast notes that since becoming a Level II trauma center in 2010, many patients are arriving in very critical condition. While clinical staff are well trained on the care to provide, says Kast, patient services staff also are encountering this new patient population.
"They are being presented with a much higher anxiety level by the loved ones of these patients," says Kast. "To assist them, Botsford Hospital's security officers have had training that helps them to calm highly anxious family and friends of trauma patients."
Through the patient's eyes
Kast is often offered helpful input from various areas of the hospital. "The best part is feedback from hours when I'm off work," she says. "The upper management team helps by rounding and reporting good and bad behaviors to the appropriate department manager."
Kast got one comment on a staff member helping a patient across the parking lot in a wheelchair to get her prescription filled at the outpatient pharmacy.
Kast says that her current focus is the ED entrance, which is the "front door" for walk-in patients. "I'm partnering with the security director, since his department and mine share the walk-in entrance," she says. "We hold joint meetings, ensuring that staff from both departments hear the same message about customer service expectations."
Kast tries to look at the hospital's ED through the eyes of patients and their family members. "I ask myself, because my people have a small area and patients don't like to see a mess, is the area clear of unnecessary stuff?" she says. "Does it appear that my people are all engaged in work activities?"
Watch and learn
Patient access supervisors at St. Joseph Medical Center-Towson (MD), occasionally call their own staff to see how they answer the phone, says Mary Crawford-Perry, manager of registration. "We make sure the call is answered in three rings. If not, then we call back to talk to them about why they didn't answer the phone," she says.
When Crawford-Perry wants to know if things are working smoothly, she uses a concept from the hospital's "lean team," which works on process improvement hospitalwide, called "20 minutes in the box."
"It is amazing what you will learn when you take the time to just watch a process," says Crawford-Perry. "This is especially true when it comes to customer service. It is kind of like secret shopping."
When a patient comes in for surgery, the front desk alerts registrars electronically, says Crawford-Perry. "Then registration knows that the patient is waiting to be registered, so the patient feels like we are expecting them," she explains.
Registrars greet the patient and introduce themselves by name, says Crawford-Perry, and in areas with offices, they go out to escort the patient in.
"We have self-check-in for registration, and sometimes patients need help," says Crawford-Perry. "We want to make sure that the patient isn't standing there, struggling with the system. There is someone right there to help them."
Crawford-Perry's biggest pet peeve is when someone doesn't introduce him- or herself by name when talking on the phone to a patient. "I call in on the weekends to see how staff answer the phone," she says. "The first thing I will tell them is, 'Please make sure you identify yourself,' if they haven't done so already."
Crawford-Perry expects staff to escort patients to a volunteer who will bring them to their destination. "We remodeled our front entrance. Some of the locations are a long walk, especially for some patients with severe health issues," she explains. "We also have greeters that will take patients if the volunteers are not available."
[For more information, contact:
Mary Crawford-Perry, Manager of Registration, St Joseph Medical Center-Towson (MD). Phone: (410) 337-1252. Fax: (410) 337-4473. E-mail: firstname.lastname@example.org.
Pam Kast, Admitting Office, Botsford Hospital, Farmington Hills, MI. Phone: (248) 471-8459. Fax: (248) 471-8217. E-mail: email@example.com.]