Combining benchmarking with other quality tools to achieve breakthroughs in admitting.
BACKGROUND
A cross-industry benchmarking study in which St Joseph's Regional Health Systems participated recommended that the admissions process (that is, preverifying insurance, obtaining demographic information) be completed before patients arrive at the hospital. To apply this best practice at St Joseph's, management established three team efforts. IMPROVING PREVERIFICATION. One team was assigned to improve the insurance preverification process. After cross-training staff to carry out preverification and piloting a electronic, on-line preverification system, the team increased St Joseph's preverification rate from 2% to 70% for scheduled patients.
After exploring solutions for an on-line system that will be integrated across the St Joseph system, the team recommended expanding the current computer system to include all entities and to integrate demographic and clinical information. In addition, a subteam reduced the number of registration forms patients must fill out from eight to one. REDESIGNING ADMISSIONS/REGISTRATION. As part of its restructuring effort, St Joseph's is redesigning six core processes, including admissions/registration. This redesign team is currently implementing two recommendations from the benchmarking study: express admitting and centralized scheduling.


CONCLUSIONS
Organizations are advised to understand the process in its current state by collecting data and working toward improvement goals--and to be prepared for changes in job functions and allocation of resources. Other recommendations are offered to organizations attempting to apply best practices from a benchmarking study.
St Joseph's Medical Center, Stockton, CA 95204.
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Covey
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DeVecchio
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Mitchell
D000289:Admitting Department, Hospital / Q000458:organization & administration / Q000592:standards*; D001071:Appointments and Schedules; D002140:California; D017598:Efficiency, Organizational; D006751:Hospital Information Systems; D006754:Hospital Restructuring; D006801:Humans; D007344:Insurance Claim Reporting; D007350:Insurance, Hospitalization; D009096:Multi-Institutional Systems / Q000458:organization & administration / Q000592:standards; D011340:Problem Solving; D017064:Process Assessment, Health Care; D012985:Software Design