Cross-training Staff

March 1, 2004

In what circumstances is it good to cross-train staff? When does that work?

Question: In what circumstances is it good to cross-train staff? When does that work?

Answer: Here are some areas where cross-training works:

Medical assistants (MAs) - If you offer ancillary services, train MAs to perform (or at least assist) in these services. Remember, however, that some clinical responsibilities - for example, giving injections - are regulated at the state or federal level; first check with your state board of nursing about the rules in your state.

Telephone operators - Operators who have clinical training can reduce phone transfers and cut down on messaging by answering patient questions themselves. Be sure to manage their role appropriately; you don't want patients to receive poor or undocumented medical advice.

Checkouts and referrals - Why make patients stand in line to check out? Collect copayments and account balances when they check in. Put computers in exam rooms so a nurse or MA can schedule follow-up visits and make any necessary referrals on the spot.

Rooming - Train a clerical staff member to be a patient-flow coordinator. This person will know the importance of accurate registration data, and can be trained to take vitals, record primary complaints, and manage the flow of traffic to make sure the physician is never idle. This position is particularly helpful for serving four to five providers at a time, who also each have a nurse to manage patient education and follow-up services, such as injections and lab draws.

Billing and front office - In most practices, nearly half of every billing staff member's job is to clean up errors created at the front end of the office. Why not cross-train so that every billing and registration staff member can do both jobs? By cross-training, you'll raise the level of expertise and reduce errors. It may cost a bit more in hourly wages, but rest assured that the drop in errors (and additional work) will allow you to do more with less staff.

Take training seriously, regardless of the position. Explore the options for training and certification for the positions you are cross-training. It takes time and support to do it right, but the return on your employee investment makes it worthwhile.

One caveat: with cross-training sometimes comes a loss of accountability. Employees can potentially "float" from one task to the next without really accomplishing anything. However, good management can ensure that cross-training instead results in an across-the-board increase in productivity, allowing you to provide double or triple your existing service.