Sunday, January 20, 2013

The Patient's Journey Starts With Us!

In most cases, the registration staff are the first person to greet the patient.  They represent the organization and this first impression will establish the patient's perception of the hospital.  In addition to providing exceptional service, the staff must ensure they register the correct patient. 

The next important function performed by the registration staff is positive patient identification.  This is essential and failure to validate the patient's identity will create a risk to the patient and to the organization.  Historically, most discrepancies occur involving patient's who arrive by ambulance through the Emergency Department.  These acute patients bypass the registration area and are transferred directly into the Emergency Department treatment room.  Bedside registration is then required to ensure appropriate patient identification and to validate the patient's demographic information.  The discrepancies occur when the bedside registration task is not completed and the staff register the patient using the EMS or nursing home transfer information.  Unfortunately, these sources are not 100% accurate and as a result the incorrect patient is registered.

The impact of registering the incorrect patient is that the physicians/clinicians are reviewing the wrong medical history, allergies, diagnostic reports and medications for the patient they are treating.  Other then the obvious health risk to the patient, incorrect financial invoicing may occur and faxing of incorrect medical reports to the family physician are risks.  Prior to the electronic medical record (EMR), incorrect documentation could be manually separated and corrected but with the EMR many IT systems are impacted.  Also, electronic medical reports, as well as, data is transmitted instantly to a variety of external recipients (family physician, specialists, Ministry, etc.)  who all must be contacted to correct discrepancies.

To resolve this situation, staff must be educated on the impact of discrepancies and the importance of their role in the patient's journey.  Also, the Ontario government's initiative to replace the old red and white health card is necessary even if it is not a popular option with existing card holders.  Mandating photo ID health cards will improve positive identification and decrease fraud.

The next important function is obtaining and validating the patient's demographic/contact information.  Many patients perceive registration to be an obstacle for receiving care.  It is essential that the hospital can contact the patient and/or their relatives regarding their care.  It may be necessary to contact the patient regarding their abnormal test results or their follow-up clinic appointment.  Also, the relatives may be contacted as substitute decision-makers for care if the patient is unresponsive.

It is important that patient's are education regarding the importance of registration and that providing their photo ID, as well as, their demographic information may seem to be annoying but necessary for their care.

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