Why it Takes an Army, Not Just a Project Manager

[Sharon K]

In my opinion a project manager needs to be onsite and 100 percent involved OR you can have a part time project manager and a strong triad of Revenue cycle Managers, including Health Information Management, Patient Access, and Patients Accounts.  Everything dealing with the computer implementation could go perfect, unlikely, but possible, but if you don’t come down from 50,000 feet to 2 feet your project will most definitely be unsuccessful as a whole.

The IT or consultant project manager will keep you on task with the software conversions and the training.  But the Triad must ensure that every patient type, every service code, every reference master and every process whether it be a once a year thing or a once a month thing, must be reviewed, tested and changes made.  A great deals of things also depend on the location of services at a facility too, even the location of the printers.  So how do you possibly improve patient satisfaction when you are required to ask patients more and more questions every day when smiling only gets you so far?  Really, how long does a conversation last when you bring up whether they would like to OPT out of the CCD every time that they come in for a visit?   As it is you can have a twenty minute discussion with a patient on ethnicity because they do not understand why that information is needed to register for blood work.  I mean don't get me wrong, I am all for improvements for the masses, but geeish some people just want to get their blood work and leave.  I know I do when I am on the other side of the counter, I digress, sorry.

I have been in working in Patient Access as a Registrar, Scheduler, Cashier, Team Leader, Supervisor, Manager and Director, but no matter what hat is on the question still remains the same. How do I please everyone? In the outpatient setting, some want to be processed super fast, some want to sit, register and chat for a moment and some don't want to register at all. For an example, where I am, we have tried a great deal of things to decrease wait times, but what we are finally doing now has raised our press ganey scores (our patient satisfaction survey), enough where there is not a bulleted question of concern from our patients anymore.  We have centralized registration and a fast track line.  These fast track patients are all scheduled pre-registered patients that we copy cards on (soon will be scanning with Paragon) , we have the patient sign and then they are on their way, no sitting, no waiting, no fuss.  For this process to work correctly, you have to have the right people in the right positions.  You also have to have the background process down to a science, especially when you throw authorizations and Medicares ABNs in the mix.  All of the walk-in patients for anything not scheduled sign in and are processed by a registrar. The cashier reviews the patient's card when she changes the account from a pre-registered state to an active status.

Back to the implementation, I realize that I need to be at two feet and really get into each process and dissect who is doing what and what is doing who.  What I mean by that is everything and I mean everything is changing.  The way we register, the way they are going to have to think, the way we print, everything. Even house -wide, people do not realize yet that their areas are really going to be affected.  I have over 200 people to train and not because they are all registrars, but because they will some how be affected by a process throughout all of the patient types and services.

For the testing phase, we have decided to use the round horseshoe type of a testing process all in one room, after all of the masters have been built and conversions have taken place.  We have decided that a folder should be used for each scenario and after each area does their piece we are going to have them sign off on the folder and at the end, the test patient chart will go on a spread sheet.  Included in the folder prior to testing, I am going to go through and find cases that we are going to test, print a registration face sheet, a physician order and a UB.  This way we can see what the current look is and what the outcome should be with the new system.  Patient Accounts is also going to give some examples that they would like to test specifically for charges, along with H.I. M. for coding, but all folders will include the same information.

I guess it is just a learn as you go process, but a Project Manager is more than one person, unless again they are onsite, guiding you through the project every week, every day, because this is a huge undertaking, in my opinion it takes an army to win this war, because it cannot be done by one person alone.            

Sharon K is a fifteen-year McKesson user with first Star, and now Paragon.