OPAC Registration process

1. May 21, 2013 OPAC Registration process

2. Phase one (May 2012) • Joint SLCH/WUSM team to develop future state registration recommendations for the OPAC • Phase two (June 2012 – present) • Adhoc groups developed to address phase one task force recommendations Two phase approach

3. Charge - to bring a recommendation to the oversight committee for handling registration and waiting at OPAC • Considerations • The patient and family experience • How current IT systems can facilitate the registration process • Current process improvement efforts underway on the main campus • Situations where joint registration happened today • Potential impact on space and FTEs Phase 1 Team charge And considerations

4. One registration Smooth flow between transition points Minimal wait for registration process Ability to go directly to your destination Staffed reception area at building front door Private practice feel Perceived family expectations

5. In most locations, patients register at each location they visit which frequently results in multiple registrations in a single day In others such as OC and HCI, patient experience is to register once, with staff doing double work to get information into all IT systems SLCH and WUSM have different required registration fields Frequency of form completion, such as consent to treat/CAFA, is widely different between institutions Current state

6. In March 2013, a current state analysis was completed at the OC and South County SCC. The processes observed were registration and check in. While the majority of the facility’s patient population are adults, the key findings should be taken into consideration for the OPAC. OC & South County SCC Current State

7. Multiple signing of the HIPAA/Consent to treat form • Multiple systems used to update patient information, which caused incorrect information to go to AMPI • Changes to patient’s demographics were completed when front desk wasn’t busy versus at time of review with patient • Some patients were checked in by Wash U employees and others by BJC employees. Key findings

8. Orthopedic Surgery office visit with Radiology and Therapy • Surgery • Pediatric office visit with Lab • Timeshare joint visits • Otolaryngology and Audiology • Neurology and EEG • WUSM office visit only • SLCH office visit only • 2 SLCH only visits • 2 WUSM only visits Patient flows for consideration

9. Overall Building Adjacency Diagram Two-Story Option ADecentralized SLCH Waiting/Registration 1st FLOOR 2ND FLOOR

10. Overall Building Adjacency Diagram Two-Story Option BCentralized SLCH Waiting/Registration 1st FLOOR 2ND FLOOR

11. Check-in and Registration will be decentralized except where it makes sense to consolidate • Suggested areas that may be able to be physically consolidate check-in/registration are: • Lab and Imaging • Pediatric Suite and Infusion • Time Share Suite and Audiology • Orthopaedic Surgery and Imaging • Where ever possible, areas seeing patients for the first appointment of the day need to complete registration for all appointments that day. Recommendations

12. Overall Building Adjacency Diagram Two-StoryHYBRID Waiting/Registration Combined Imaging and Lab 1st FLOOR Combined TS and Audio Combined Peds and Infusion 2ND FLOOR

13. Evaluate and standardize the registration process between SLCH and WUSM Cross-train WUSM and SLCH staff to facilitate registration of all patients regardless of service utilized. Standardize required registration fields between SLCH & WUSM Standardize frequency of form completion requirements Develop process to share scanned documents such as insurance cards between SLCH & WUSM Next steps

14. APPENDIX

15. Phase one Task force members • WUSM • Kelley Mullen • Jennifer Albertina • Sheri Farber • Ron Faulbaum • Joy Haven • Dana Sterbenz • SLCH • Angie Woods • Pam Carpenter • Sharon Bader • Debbie Joseph • Roanne Karzon • Jean Stroud • Mary Cody