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There’s no magic,’ just hard work, consistency
Focusing on good customer service was a tradition at Albert Einstein Medical Center in Phil adelphia when Anthony Bruno, MPA, became director of health care access management two years ago, but the challenge he faced was making the philosophy work in the access department.
"Impressive customer service has been a breakthrough objective for the Einstein Healthcare Network," he says. "From the top down, everyone is looking at it in their areas and trying to develop strategies."
In fact, the Philadelphia-based organization’s reputation in that regard was one of the reasons he wanted to work there, Bruno points out. "Wendy Leebov, the vice president of human resources, has been a national spokesperson for customer service since the 80s."
His mission became manifesting that idea in access management, he says. Not the least of his motivations was to bring respect and recognition to what historically has been one of the most undervalued parts of any health care organization. "It’s so terribly important, in an era of downsizing and people losing their jobs, to express the extreme value that patient access has."
Bruno’s effort — a five-faceted approach to developing impressive customer service — garnered him the 1998 Einstein Award for Customer Service and "has really put our department on the map," he says. "There’s no magic. It’s just hard, conscientious, consistent ways of working with staff." The improvements happened, Bruno adds, by breaking the process into these directives and devising specific ways to follow them:
• Recognize and anticipate customer expectations. With this goal in mind, Einstein came up with innovations ranging from a preadmission services brochure with free parking pass to a single patient consent form and a wireless registration system. A patient handout titled, "Read any good insurance cards lately?" explains that financial penalties might be incurred by not following the precertification requirements specified on the cards and offers the phone number for financial counseling for further help. On the back is an insurance requirements checklist. (See patient handout, p. 91.)
• Define staff behavior expectations. To meet this objective, the access department developed a mission statement outlining its responsibilities and goals. Job tasks for registrars and financial counselors are clearly outlined. In addition, access employees are asked to complete and sign a form indicating their commitment to "delivering continuous impressive customer service." In making that commitment, the employees list specific behaviors they will integrate into their jobs to achieve the goal.
• Educate/train staff. The department implemented two new forms of communication to achieve this objective, explains Marina Zeccardi, manager of administrative services for health care access management. "Code Green," named for its financial focus, is a quarterly newsletter that goes to access staff both at the hospital and at registration sites throughout the network. "Although these employees are not under our control, they deal with the same issues," notes Zeccardi, who writes the publication with the help of the patient accounts department.
Printed on green paper, the newsletter emphasizes that access staff "are not really registrars, but front-end billers." It notifies staff of insurance name changes and computer system updates and is a forum for questions and answers. Educational features include, for example, explaining the difference between a preferred provider organization and a health maintenance organization.
"Hot Off the Presses" is a one-page notice to all registration areas of items that need immediate attention. "It may be that we just found out we have a new financial class," Zeccardi says. Another message alerted employees that entering the effective dates for patients’ insurance on a registration needed special attention because of year 2000 complications. "It’s an eye-appealing, fun way to approach serious information."
The "What’s Hot Hotline" is a dedicated telephone line staff can use to find out about new programs, code changes, and upcoming meetings. A recent message, Bruno says, informed employees that a new laser jet print system was going live that day. Other educational efforts include a physician office staff orientation breakfast, and the assignment of individual employee mail slots for memos and other correspondence.
• Demand consistency. Outpatients at the Albert Einstein Medical Center carry a Patient Flow Card on which staff record the patient’s arrival and departure times at various ancillary departments. "This is the patient’s passport’ as they arrive at different services," Bruno says. "We use it to guide the patient, but also to do a quality review. If we want to get through preadmission in less than two hours, it takes a team effort."
On the back of the Patient Flow Card is a customer service survey, which asks such questions as, "Were you greeted in a friendly manner?" and "Did you receive service in a timely manner?" The cards are given to patients when they arrive for an appointment and collected before they leave.
To promote accuracy, Zeccardi randomly spot checks patient registration forms. (See spot-check form, p. 92.) "We look at what was right and what was wrong," she notes. The employee who did the registration gets a copy of the review, as does the manager.
• Reward staff with recognition. To recognize employee efforts, Bruno instituted an annual health care access excellence award, with the recipient honored at a ceremony during health care access personnel week, held the second week in April in conjunction with the National Association for Healthcare Access Management observance. Special events throughout the week include an employee breakfast, an international foods luncheon, raffles, and a white elephant swap meet.
Efforts to promote and monitor customer service are varied and ongoing, Zeccardi points out. The department has conducted telephone surveys to determine if employees answer the phone according to a prescribed script. "We had a listing of all [access] extensions and did it once a month for four months, picking two or three phone numbers in each location," she adds. "That’s simple, something anyone can do. Sometimes we tend to think broad instead of getting down to the nitty-gritty."
At the end of 1998, she says, the department participated in a networkwide "secret shopper" campaign. "A representative from another department would come in unannounced, pretending to have an appointment," Zeccardi adds. The secret shopper rated the experience. "Our [results] were very positive," she notes.