Revenue Cycle Management Source: The Academy of Healthcare Revenue
Preparing for the Unexpected By Utilizing Crisis
Management Strategies
Hospitals face a number of potential crises
within the healthcare industry that
the general public may hold these facilities
accountable for, including high medical
costs and lack of access to comprehensive
health insurance. Considering
these public concerns have chiefly to do
with the revenue cycle, leaders must identify
strategies to effectively manage such
crises through operational enhancements
and effective communication.
Any time a hospital is faced with a crisis,
the way in which it is handled will
largely determine how and on what level
it may affect the hospital. Uncomfortable
interactions between patient access
staff and patients, an internal systems
failure that may have affected HIM processes,
or major billing errors could all
be considered crisis situations that revenue
cycle staff may be held accountable
for by the public. A hospital can be faced
with intense scrutiny and serious consequences
in this instance, so it is important
that such occurrences are appropriately
handled.
There must be specific plans for both
external crises (e.g., natural disasters
causing capacity and patient throughput
issues) as well as internal crises (e.g.,
operational malfunction or process failure), because both kinds of crises affect
the hospital differently. Following are
steps that revenue cycle leaders can take
in response to an internal crisis:1
Assess the Situation. In the instance
of a crisis, it is important that all assessments are made immediately
and correctly without making any
assumptions in order to avoid further
mistakes.
Designate a Spokesperson. There
should be one individual solely
responsible for relaying information
to the community, or to public
relations representatives who will
convey messages on revenue cycle
departments’ behalf. Ensuring there is
one spokesperson minimizes chances
for rumor and confusion among media
and the public.
Give an Immediate Response. Delaying an appropriate response
can cause irreversible damage, so
action must be taken immediately and
effectively. If an immediate response
is not possible, ensure those seeking
information that you will follow up
with them as soon as information is
available, and keep that promise.
Ensure Order. Every circumstance
requires its own set of steps in order
to be resolved. Management must
exercise discretion when deciding how
to go about addressing the issue at
hand, and have an action plan ready
for staff to follow in order to avoid
disorganization.
Be Conscientious and Courteous of
Family Members Involved. One of the
most difficult aspects of internal crises
is the affect it may have on patients
and their families. Management
and staff must do all they can to be
reassuring and helpful to patients and their families, displaying genuine
concern and willingness to assist in
resolving issues.
Not all crises are within the hospital’s
immediate control, such as a natural
disaster or pandemic. In such cases, revenue
cycle leaders must have a detailed
plan on file to provide guidance and education
for staff in handling external crises.
To ensure preparedness, leaders can do
the following:2
Gather Information. After determining
who will be involved in formulating
the specifics of a disaster plan, the
team selected can conduct an impact
assessment and recovery strategy.
Doing so will help identify methods
to handle potential issues, such
as patient access staff response to
incoming patients from a nearby crash
or HIM staff’s protection of medical
records at risk for damage due to
flooding.
Formulate and Test the Plan.
Following the identification and
in-depth discussion of the risk
and recovery plan, the emergency
preparedness plan should be
documented and given to every
employee. The recovery plan must
then be tested through department-wide practice runs so it will be more
effective when needed.
Plan Maintenance. It is important that
the emergency plan is kept updated
with any systematic changes. If
necessary, the management team can
conduct meetings to keep abreast of
any new developments or issues that
may affect how the recovery plan is
planned and executed.
For any kind of crisis situation, there
is no substitute for overall preparedness
and strong leadership, especially for
financial concerns that fall under revenue
cycle departments’ purview. Management
is largely responsible for the execution
of an effective emergency plan; therefore,
their preparation is vital to ensure
patients’ safety and the hospitals’ financial
recovery if a crisis occurs.
1 Patrice Spath, “Plan for Panic,” For the Record, 6
August 2007.
2 Patrice Spath, “Ready for an emergency? Don’t wait
to find out,” For the Record, 14 May 2007.
The Academy of Healthcare Revenue
The Academy of Healthcare Revenue is a membership-based community that provides healthcare leaders with objective research focused specifically on the healthcare revenue cycle. Members receive an unlimited supply of all research--including benchmarking and best practice reports, implementation tools, monthly journals, attendance to virtual conferences, and more--designed to enable them to improve their revenue cycle processes and financial health from within. Furthermore, The Academy's membership offering is tailored to team members throughout the revenue cycle, from executive leadership to patient access, coding, billing and collections, and clinical staff, helping to drive process improvement efforts revenue cycle-wide. Collecting in Healthcare is one of four journals written by The Academy of Healthcare Revenue monthly.
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