Perhaps one word best described Skagit Valley Hospital's customer service in its patient access department a few years ago: poor.

That was not the only problem for the Mount Vernon, WA, facility, says Michele Hill, CHAM, its patient access manager who joined the team in June 2006.

"One of the first things I did was an initial assessment to see where things stood," Hill says. "It was obvious from the very beginning this department was in crisis."