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The Move to Decentralization

Patient Access Weekly Advisor, February 27, 2008

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Wait times are shorter in decentralized. After all, if you are there for a laboratory test, and you're at laboratory registration, the process is expedited.

There are disadvantages, access managers say. What happens when a staff member is sick, and there is no one to fill the slot except a central registrar who is not privy to the nuisances of laboratory registration?

The fact is, there are pluses and minuses about which registration your facility chooses. The key, access managers say, is to analyze your facility and find the right fit.

Sarah Garrett, patient access services (PAS) applications analyst for the Olympic Medical Center in Port Angeles and Sequim, WA, says her facility switched to decentralized registration over time because of growth.

The department has 20 staff members and is a 126-bed facility. The bulk of its patient population is approximately 60%-70% Medicare. Its services include cardiac services, imaging, dietary, new family services, lab, same-day surgery, infusion/chemotherapy, physical therapy, wound ostomy, medical/radiation oncology, and physician clinics, both specialty and primary care.

"As our growth increased, we needed to spread our services around, not only because of physical space limitations on our hospital campus, but because we were trying to offer our patients a more convenient way to access the healthcare they needed," Garrett says. "When I think about the diversity of services we offer, it is important to realize that although the job functions for registration are basically the same, there is a lot of variance in the work process."

At Olympic, the PAS department never closes and operates the communications center/switchboard and staffs the ER registration area. It also handles the registration areas of cardiac services and short-stay surgery units and registers patients for outpatient services in the hospital and all inpatient/observation admissions.

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