As Northern Hospital of Surry County moved from one manual solution for tracking registration errors to another, Terry Hancock, manager of patient access and customer service, says she “kept thinking that with so much human error and emotion going into the effort to be 100% accurate, there had to be something out there that could do this automatically.”
The hospital, located in Mount Airy, NC, had gone from checking all registrations to examining a percentage, and then back to doing a 100% review, she recounts. Much staff time was spent looking at registrations and sending them back to supervisors, then to representatives to be fixed and then back again, Hancock adds, and by that time, the bills had dropped.
Later, she notes, there were weekly training classes for registrars whose accuracy average dropped below a certain percentage. “We’d go over major errors and how to avoid them, without pointing out any one person, still trying to be very sensitive. What we finally understood is that with the number of pieces of information to know in a busy, busy outpatient area and an unpredictable emergency department, you can’t know them all.
“No one comes to work to make errors,” she adds. “Everyone comes prepared to do the best they can, and they still make errors. All of the encouragement and retraining in the world couldn’t stop these sometimes silly errors.”
Hancock, who worked in the airline industry for many years—most recently managing the customer complaint analysis area—says she knew from experience that there must be an automated means for the hospital system to gather and process its quality assurance information.
The airline representatives, she recalls, recorded all of the customer complaints in specific coded fields in a computer system, including “what, where, when, why codes; flights; dates; and city pairs” to define the actual customer concerns.
“We then used access queries, sequel logic and other systems to pull that information from those fields,” Hancock adds. “Being able to specify captured data fields is what enabled us to analyze and drilldown into massive amounts of information to create meaningful and actionable solutions.”
What the hospital needed, she realized, was a system that could measure fields, take them into another system and check for accuracy—that could scour through hundreds of registrations a week and find the errors that took up so much of the staff’s time.
“You can’t replace human intelligence, but with about 85% of the errors we had—tiny and big things—you could stop and at least make folks go back and look at them,” she says.
Before deciding on the error tracking tool the hospital ultimately chose, Hancock says, “we looked at four other systems that all had good points.” A couple were ruled out because they didn’t work in real-time, she adds, which meant that a relief employee who was on the job one day but not back again for a week couldn’t correct her errors in time to make a difference.
With a real-time system, employees could fix their errors and have the benefit of immediate feedback, Hancock notes. “What I wanted wasn’t a punitive grading system, but for these folks to come to work, give it their all and feel good at the end of the day about what they had done—and for the hospital to have clean billing [upfront] rather than fixing it on the back end.”
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