Hospital Department Leaders Must Remain Flexible in Difficult Economy

Dom Nicastro, for HealthLeaders Media , June 16, 2009

Sometimes, your health information managers need to code. And your patient access managers need to register patients.

In these tough economic times, your hospital staff members should be ready for different roles on any given day. No one is immune to change.

At Albany (NY) Medical Center, managers in the patient access department are prepared to handle staff shortages.

During a recent string of illnesses and consecutives days with short staffs, department leaders took off their managers' hats and got on the frontline to register patients.

"The leadership team are working managers, much like any other patient access area," says Cathy Pallozzi, CHAM, patient access director at Albany Medical, noting the staff recently experienced colds and GI, which sprang the managers to action. "So the managers are on the front end, as well as the associate director. If I am needed, I will be on the front end as well."

Albany plays the game of position musical chairs well because the facility prepares, Pallozzi says.

"I have always been from the school of thought that you need to maximize your resource always," Pallozzi says. "In times such as these, it is no different then when you are so busy you do not have enough resources."

Pallozzi says "cross training" is the key. Managers are ready to register patients, obtain authorizations, place patients, and collect copayments and balances.

"Cross training has been and will always be a primary focus for my leadership team," Pallozzi says.

Albany's patient access team created a spreadsheet of tasks and chores–no matter how small–to help move it forward. The medical center called them "re-engineering/efficiency" opportunities, and staff must answer four questions for each task:

  • What is the added value in performing this task?
  • What does it cost in resources (FTE or hours)?
  • Is there a cross training opportunity?
  • Is there a redundant process that you are aware of?

Its goal is to gain efficiency, maximize their resources, and "assure that we are working together to problem-solve staffing concern, volume influx, and meeting our patients' needs," Pallozzi says.

Albany's copayment collection remains strong, Pallozzi says, and its pre-encounter telephone calls assist in ensuring the patient knows what is expected. While it has had a dip in its elective surgeries, the medical center's ED and outpatient volume remain strong, Pallozzi adds.

It helps that Albany's managers are always ready for the next challenge, Pallozzi says.

"They are acting as a staff member–the full scope of the registrar responsibilities," she says.

Editor's note: This is the third in a series of stories on HealthLeaders Media talking to revenue cycle managers about coping in a tough economy.


Dom Nicastro is a contributing writer. He edits the Medical Records Briefings newsletter and manages the HIPAA Update Blog.

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