Stephanie Barnett, director of consulting services at Health Blueprints, an NCO Group company, and Barb Shields, manager of patient access/centralized scheduling/central billing office at St. Francis Health Center in Topeka, Kan., discussed centralization of patient access services in a recent webinar presented by Becker's Hospital Review.
St. Francis worked with Ms. Barnett to centralize pre-registration, scheduling and patient billing services. The hospital now has a scheduling maximizer, physician order facilitator and provider portal to ease access to these services. In the webinar, titled "Centralized Patient Access Improves Patient/Physician Satisfaction and Financial Results: Preparation, Challenges and Lessons Learned," the presenters used their experiences at St. Francis to provide the steps necessary to receive both financial and non-financial benefits from centralization.
Preparation
"Preparation was the key to successful implementation of centralization at St. Francis," Ms. Barnett says. Preparation involved several components:
1. Homework. The first step in preparing to centralize patient access services is gathering information on possible financial and staffing effects of the change. Hospitals should build a projected return on investment from the project based on the implementation of technology and redistribution of staff.
2. Teamwork. Taking a multidisciplinary team approach to patient access centralization was critical to St. Francis' success, according to the presenters. The team included senior leadership, clinical department managers, IT personnel, the human resources department, physician champions and end users. Involving a variety of individuals allowed the hospital to more easily communicate with all stakeholders and gain the support of departments that would be affected by the initiative.
3. Communication. To successfully centralize patient access services, hospital workers need to step outside their own silos and communicate across departments. Ms. Barnett says one of the contributing factors to St. Francis' success was the team members' commitment to open communication from the beginning. Furthermore, team members communicated not only internally with each other, but also externally with the physician community. St. Francis held monthly lunches with physician practices in the community to educate them on the hospital's initiative and gain their feedback on the project.
4. Cultural alignment. Hospitals need to understand their current culture and determine common goals of the centralization initiative. At St. Francis, while initially the organization focused on the financial benefits, it learned that to align everyone's goals it also needed to focus on ease of access to services for patients as well as patient and physician satisfaction.
5. Human resources. Involving human resources from the beginning is also an important part of preparation. The HR department facilitates communication with and support of employees as they transition to new positions or areas within the organization.
6. Financial policies. Hospitals need to update financial policies related to registration and patient payment before implementing new technology and processes that centralize these services. Senior leaders should work together to agree on the organization's current financial philosophy and what policies they want in the future.
7. Technology/telecommunications. St. Francis created a new phone system and adopted several new technologies to optimize the centralization of patient access services. These changes helped the hospital reduce its percent of dropped calls from 10.6 percent to 1.88 percent in a year, according to Ms. Shields.
Challenges
One challenge St. Francis faced came from a corporate initiative, which reduced the hospital workforce and implemented a hiring freeze before the go-live date of the new centralized services. This decision affected some of the individuals involved in planning the project and some of its leaders. Despite the reductions in staff, the Centralized Patient Access Services Center opened without hiring additional headcount. Other challenges included finding space for the centralized patient access area and working with staff members who were resistant to change. Ms. Shields says project leaders had to be flexible, communicate openly and think outside the box to overcome these challenges.
Lessons learned
Ms. Barnett and Ms. Shields highlighted several lessons they learned from the project at St. Francis that could help hospitals considering a similar initiative.
1. Develop a purpose statement. A purpose statement helps guide the team towards a common goal.
2. Focus on physician and patient satisfaction in addition to financial benefits. Emphasizing the benefits to patients and physicians also helps unite team members around a common goal.
3. Be flexible. Continually reevaluating the project plan allows team members to build better processes and overcome unexpected challenges.
4. Document decisions. Documenting decisions is important because the documents can be used as a reference when reevaluating plans and communicating with stakeholders.
5. Benchmark. Capturing accurate and complete data early is important to correctly forecast changes in staffing and assess the effect of new processes around patient access services.
6. Form allies and strategic partnerships. Partnering with other departments and with community members eases communication and builds support for the initiative.
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Download a copy of the presentation by clicking here (pdf).
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