CHAA Examination Preparation Future Development – Session II Pages University of Mississippi Medical Center

What to Expect… This module covers various aspects of Patient Access knowledge found in pages of the FUTURE DEVELOPMENT section of the 2010 CHAA Study Guide. A quiz at the end will measure your understanding of the content covered.

Staff Education and Competency KEY PERFORMANCE INDICATORS (KPIs) are created to help an organization DEFINE and MEASURE progress toward organizational goals. They reflect the CRITICAL SUCCESS FACTORS. They must be QUANTIFIABLE(measurable). Examples: 97% Accuracy Rate, Register X amount of patients per hour, Patient wait times less than X minutes, Point of Service Collections, etc.

Revenue Cycle KPIs In the past, hospitals focused a majority of their efforts at the end of the Revenue Cycle. –What is wrong with this process? Most revenue cycle problems occur when the hospital is collecting and verifying patient information needed to ensure a clean submission claim and receipt of full payment. –So how would you address this problem?

Performance Improvement Methods PROCESS IMPROVEMENT is the act of INCREMENTALLY exceeding the requirements through continual ENHANCEMENTS and REFINEMENTS. There are SCIENTIFIC and SYSTEMATIC methods, techniques, and tools used to improve performance. Before you conduct process improvement, the OBJECTIVES and OUTCOMES must be MEASURABLE and WELL UNDERSTOOD.

FOCUS - PDCA The purpose of FOCUS – PDCA is to improve the product or service from the CUSTOMER’S VIEWPOINT. F – Find a process improvement opportunity O – Organize a team who understands the process C – Clarify the current knowledge of the process U – Uncover the root cause of the variation or poor outcome S – Start the “Plan-Do-Check-Act” Cycle

Six Sigma Six Sigma is a process improvement technique using organizational wisdom and statistics to identify and eliminate the “DEFECTS” in a process. A “defect” is anything outside of customer expectations. It focuses on making sure we’re doing the right things correctly the very first time.

Lean Lean and Six Sigma are complimentary in nature. Lean focuses on ELIMINATING NON-VALUE ADDED STEPS in a process. Lean ensures we are focusing on the RIGHT THINGS.

Process Reengineering This involves FUNDAMENTAL RETHINKING and RADICAL REDESIGN of business processes to achieve DRAMATIC improvements. Changes must be: »Radical »Dramatic »Contemporary

Flowcharts & Process Maps A Flowchart is a graphical representation of activities that make up a process. –Steps taken in registering a patient A Process Map is a graphical picture of the actual workflow through a company. –This helps clarify who is responsible for a step or a task in the process

Patient Access Training Models Hands-On Computer Training Formal Classroom Training Peer-to-peer training Self-paced Training Role Playing Experiential CBT (Computer Based Training)

Patient Access Training Modules Computer systems Training Customer Service Standards Insurance Verification Pre-Certification Calculating Patient Liability Overview of healthcare finance Medicare/Medicaid Managed Care Revenue Cycle Ops Medical Terminology Scheduling Regulations: HIPPA, EMTALA, etc.

Competence Competence is a STANDARDIZED requirement for an employee to properly perform a specific job. It encompasses a combination of skills, knowledge and behavior. Two Types of Competencies are: –Behavioral and Technical

Behavioral and Technical Competencies BEHAVIORAL COMPETENCIES are learned through life experiences which form our behavior patterns. –The ability to get along with others, adapt, be a team player, have a positive attitude, maintain composure under pressure, etc. TECHNICAL COMPETENCIES are learned in an educational setting or on the job. –Registering, verifying information, calculating deposits, the ability to read and write, etc.