Situation:
This project took place in a short term, acute care hospital of 216 beds located in a suburban city. Masters Associates was contracted to perform an operational assessment and determine individual skill levels of the staff and Manager of the Registration Department. The new Director of Patient Financial Services was knee-deep in a process improvement project in the Business Office and did not want to ignore Registration in the meantime.

The Registration Department had seen very little change in procedures, staffing, or function in several years. Outpatient Registration was open well beyond the hour when patients stopped arriving for tests, while the Emergency Room registrar struggled to keep up. Scheduling, Pre-Registration, and Insurance Verification were done in separate locations in the hospital making it necessary to ‘walk' information back and forth. Production levels were very low. There was no formal training for new employees, resulting in many errors and operational issues.

Masters Associates Main Objectives:

• Supply written assessment of each Registration staff member
• Provide recommendations for improvement of Registration Process and Design
• Compare current and proposed work flow
• Develop a work-plan including timeline for each task
• Implement work-plan
• Provide interim Registration Manager

Approach:
Masters Associates interviewed each Registration staff member to determine their skills and knowledge while observing existing procedures. Masters Associates reviewed the Policy and Procedure Manual, compared against reality to identify necessary updates and wrote new policies as requested. Masters Associates' consultant met with other department heads to formulate solutions to operational issues related to Registration. After reviewing current and necessary Registration procedures in each area, a volume study was performed in order to determine any discrepancies in staffing vs. volume.

Results:
Staffing levels and hours of operation were changed to better meet patient satisfaction and increase productivity. FTE hours were re-distributed to allow greater flexibility of schedules during vacations and call-offs. Scheduling, Pre-Registration, and Insurance Verification areas were combined into one area and staff was cross-trained for improved efficiency. The hospital's Policy and Procedure Manual was updated with process flowcharts demonstrating the improved work flow.