A Driving Force in Your Business

Mar 1, 2001 12:00 PM, Tiffany Kobashigawa

HOME MEDICAL EQUIPMENT PROVIDERS are more than just “equipment jockeys” — and that goes for their delivery technicians, too.

These employees do more than just deliver and set up equipment and throw in the occasional supplies to go with it. They help train customers about equipment use and care. They gather important feedback about your products and services. And they are sometimes the only personal contacts your customers have with your company.

You carefully consider every other aspect of your business' performance and image. The hiring and training of your delivery technicians should be no different.

The Right Kind of People

IF HAVING competent delivery technicians is as important as having quality products, how do you find them? You can't test them at a trade show or look up their specs online.

The providers interviewed here all agree that word of mouth is a good way to find techs. Some have also had good luck finding candidates at local colleges. “A lot of the guys I have at the shop are college kids, and I encourage that because they tell other college buddies who might need a job when I'm looking for people,” says Robert Harry, president and owner of Ozark, Ala.-based Aabon Home Health Center.

No matter where they recruit delivery technicians, providers say they're looking for attitude — not necessarily experience. “You should start assessing job applicants on whether they care about other people and will be dedicated to customer service,” says Jay Enos, owner of New Bedford, Mass.-based Enos Home Oxygen and Medical Supply.

As the following story illustrates, you can't measure the value these kinds of people bring to the job. “I once had a delivery technician make a very brave call to judgment,” Enos recalls. “He felt that a patient was being abused, so he told me about it, and we reported it. We later found out that the patient had been held hostage by some teenage squatters who turned his home into a drug haven.”

That scenario is not typical of the daily route, yet it illustrates just how important it is that delivery technicians focus on patient needs — a skill provider Jeff Willard says he won't do without.

“I hire people who seem to have an aptitude for asking what the patient needs,” says the home health manager of Horton and Converse, an HME company at Cedars-Sinai Medical Center in Los Angeles. “A pet peeve for me are drivers who don't ask questions and are not able to answers questions when they are in someone's home. All the guys I hire have to have this ability. A delivery technician can always be trained. I look for motivated and dedicated people.”

Ready for Anything

IN TOWNS such as Ozark, Ala., where Aabon is located, delivery techs must be flexible and ready to handle severe weather, too. “We have had tornadoes that dislocate our patients, and we have to make sure that we are available for them when they call us and tell us they are OK,” says Harry. “Then they expect us to get their medical equipment to them right away.

“In 1995, we had a hurricane sweep through here and were without power for five days,” he continues. “That meant that we had more than 100 patients to service who had no power. We had to run oxygen cylinders five days a week for 24 hours.”

When hiring drivers, Harry says he looks for flexible people who will be dedicated to the job at times such as these — and when confronted with the more mundane details of the daily route. “Remember, oftentimes when we first meet patients, it's in their house among their dirty dishes and dirty underwear, unless they have a dedicated caregiver to help them out,” he says.

It can take three months or more for providers to know if a new delivery technician will work out. But, Willard says, “you will be able to spot good ones right away after you have been in the business for a while.”

Enos says he gives new hires about six weeks of training before he allows them to visit patients on their own. This time spent in-house also allows him to complete a background check, drug test and reference check. New hires spend days learning about infection control, safety training, maintaining and operating everything from a bed to a bi-level CPAP, and about proper paperwork procedures.

“The in-house training gives them a sense of accomplishment and the chance to finish the four-page competence checklist, which breaks down the areas of training they go through before they go out on their own,” says Enos.

Basic Training

PUT BLUNTLY, an employee's knowledge — or lack thereof — can lead to patient loyalty or defection. And while thorough training of delivery technicians can be extensive, having confidence that your employees know what they are doing in the home before they get there is well worth the investment you make in them.

“The best you can hope to find [from an inexperienced delivery technician] is somebody who has a commercial driver's license,” says Arnold McMann, managing director of the HME service line at The Corridor Group, a consulting firm based in Overland Park, Kan. So the first thing to do with new hires, he says, is train them on the basics of HME and safety.

By training's end, your delivery technicians should know how to operate, deliver, set up and clean any and all products they might be asked to deliver or use, from beds and wheelchairs to oxygen analyzers and flow gauges. They also must be familiar with applicable rules and guidelines of the Occupational Safety & Health Administration, available online at www.osha.gov, and the Department of Transportation guidelines, which can be found at www.dot.gov. The DOT, for example, has mandated certain ways of handling and transporting liquid oxygen cylinders.

In addition to knowing how to drive equipment around and set it up, technicians should know their way around a warehouse so they can help handle, store, receive and ship products. “Sometimes these guys perform all of these functions depending on the size of the company and how duties are rotated,” says McMann. “Typically, they will ‘route out’ in the morning and then work the warehouse. From a best-practices standpoint, you would have dedicated people performing these functions [separately], but sometimes that's not practical.”

To make sure your delivery employees are “set up for success,” Willard suggests, “put systems into place to train people yourself.” And, of course, make sure they are properly licensed and certified. All this takes effort, he says, but in the long run will be easier on you and your business.

If it seems that the technician is not getting the hang of things, McMann suggests following a three-step process. The first step is counseling with additional training. The second is assessing your expectations and the employee's workload. Finally, re-evaluate the system.

Beyond Delivery

FORGET ABOUT the products themselves — learning how to do the paperwork associated with their delivery, repair and maintenance can be more difficult to learn.

Compared with other types of deliveries, such as those from United Parcel Service, the amount of paperwork required for HME products is extensive and complicated. Technicians must understand reimbursement rules well enough to explain them to patients and review their financial responsibility and insurance information with them.

“They have to discuss the paperwork with the patients; it's mandated by the Joint Commission on Accreditation of Healthcare Organizations,” says Willard. “And drivers should be able to make recommendations when they review the specifics of the equipment in the patients' home. When a piece of equipment is delivered, technicians should know the price, be able to articulate the type of product being sold to them, know how to use it and know how frequently it needs to be changed or disposed of.”

If the delivery paperwork is not done correctly, it can put reimbursement at risk, notes McMann. “If you verify the wrong person's card and are not sure about the beneficiary's details, who's going to get the bill and how are you going to get paid?” he asks. “It's disastrous to your cash flow if you have to continually bill insurance over and over.”

As part of the orientation period, delivery technicians need to learn the role they play in the billing process. That's why learning the proper paperwork procedures takes up to two weeks during the initial training process, says Charles Mitchell, general manager of Enos.

Getting the paperwork incorrect is a frequent problem for drivers. “There is going to be an error rate that you have to live with, so always have somebody in billing reviewing the paperwork with plenty of checks and balances in place,” Willard urges.

Over the Long Haul

MITCHELL OFFERS another training caveat: Because of the constant stream of new products and technologies, education must be an ongoing process. “You want to offer the latest equipment to your patients, but your employees have to know how to use it first,” he says.

Mitchell, who started at Enos 23 years ago as a driver, is today responsible for training the company's drivers — and staying one step ahead of them in product knowledge. “I'm constantly in school and training myself so I can teach the drivers during in-service [training at the company's warehouse],” he says. “Training on every piece of equipment is key. There are so many things that are new in the market, and we have to know how to use them.”

To assess delivery technicians on their product knowledge and skills, Mitchell conducts unscheduled ride-along trips. Make them sporadic enough, says Mitchell, to keep the element of surprise but frequent enough to get a good sense of each employee's work habits while on the road.

HME providers agree that it's tough to keep good, loyal people who could make more money elsewhere doing a job with less responsibility. But if one of your drivers has stuck with the job and shown loyalty to the company, what's the best way to keep him or her thriving?

“I give bonuses and pay overtime whenever necessary,” says Enos, who also boasts a low turnover rate because, he says, “I don't treat employees like they are disposable. I treat them like they are part of a family team.”

Keeping That Right Person

UNFORTUNATELY, KEEPING well-trained technicians is not always easy because often, when they become adept at their jobs, they demand more money, and sometimes your budget doesn't allow for that. The providers interviewed here report that two or three years is the average length of time it takes for a driver to want to move up — or move on.

But in the best-case scenario, your drivers are promoted within and will use their knowledge to educate other technicians.

“I am a more dedicated and professional general manager because I used to be a driver,” says Mitchell. “I want our clients to know that we care about them, and that's what I try to teach the new guys.”

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AAHomecare Certification

THE TRAINING of a delivery technician is an intensive and involved process — one that does not end when the standard 90-day orientation is up. Continual training is always a necessity.

The American Association for Homecare attempts to ease the burden of training by offering several how-to videotapes about handling equipment in patients' homes and the warehousing of equipment. The organization also offers a delivery technician certification program. Partly sponsored by AAHomecare and state associations that request it, the certification program is offered once a month nationwide.

“We educate delivery technicians on everything from the Joint Commission on Accreditation of Healthcare Organization's regulations and the Occupational Safety & Health Administration procedures to car accident procedures,” says Terry Judd, education and meeting assistant for AAHomecare.

“Certification is generally offered at the same time as the associations' monthly meetings [and has] an average 30- to 67-person attendance,” Judd says. Students must get at least 80 percent on the multiple-choice, essay and true-and-false test in order to pass, she says.

“Going through the certification process was great,” says Brian Harry of Aabon Home Health Center in Ozark, Ala. After being in the business for five years, he took the class last year. “One of my largest rewards and constant challenges is that this is one of those businesses that you can constantly learn about.”

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The Salary Picture

According to HomeCare's September 2000 Salary Survey, the average delivery technician salary to start is between minimum wage and $10 an hour. Here's a look at statistics gathered about delivery technicians, including average salaries by region and company revenue, as well as percentages of techs who work full time and part time.