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ED bedside registration: When it does not work

Patient Financial Services Weekly Advisor, January 23, 2009

Editor’s note: Last week, we talked to a patient access manager who said her facility succeeds using bedside registration in the emergency department. This week, another manager says it only causes problems:

Lee Memorial Health System in Fort Myers, FL, has a bedside registration protocol that is simply “not efficient,” according to Colleen Edwards, system director of Registration and Patient Business Services at the five-hospital, 1,500-bed system.
For her facilities, bedside registration causes:

• Frustration among clinical staff who view registrars as interrupting the care process
• Discomfort for registrars trying to conduct business in a traumatic environment.
• Addition of staff members to cover overflow units in the ER.

“In general what I’ve learned since we’ve done this – and we’ve been doing it for a good five-plus years – is that patients here are to be treated as expeditiously as possible, but our function gets in the way,” Edwards says. “We become extremely inefficient. A nurse comes in, we step back out. A doctor comes in, we step back out. It is the least efficient system we have.”

You as the patient access manager must fully guage whether or not bedside registration will work for your facility before diving in. And you must have a solid communication plan in place with the clinical team long before the initiative is rolled out.

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