How to Stop Those Money-Draining No-Shows

Shelly Reese

Disclosures

November 20, 2012

In This Article

Convenient Appointments Are Crucial

The Peterson Clinic, a Federally Qualified Health Center in Woodland, California, traced its 30% no-show rate to limited access and failing to put the patient's needs first, says clinic manager Harpreet Ma.

Until November 2011, the clinic was scheduling appointments 3 to 4 months in advance. Patients who needed to get in sooner often relied on the clinic's walk-in service. Ma says that she would often arrive at work at 7:30 AM to find a couple dozen people lined up outside the clinic, hoping for one of the day's 12 walk-in appointment slots, which were awarded on a first-come, first-served basis. No-shows were particularly a problem during the summer, when farm workers and employees at a nearby cannery had trouble getting away from work.

"We needed to create access so that patients could get an appointment when it was convenient for them, not for us," Ma says. The clinic expanded its evening hours and created a modified open-access system that allows for 6 same-day appointment slots each day.

Now, staffers begin the day by "scrubbing" the schedule, canceling appointments with patients who don't need to be seen. That might mean canceling an elderly patient's appointment because she was seen a few days earlier for an acute problem and had her blood pressure checked at the time, or it might mean canceling a diabetic patient's visit because a review of his laboratory results indicates that his condition is under control. Scrubbing the schedule and patient cancellations create openings for patients who haven't made appointments in advance.

The clinic has likewise redoubled its efforts to reach out to patients with reminder calls.

"We've tried calling 48 hours in advance," Ma says. "But we find that patients forget less often if we make the calls the day before." Staff members use the calls as an opportunity to establish a relationship with the patient and to preregister them, so their time in the office is shorter.

On the day of the appointment, the front desk follows up with "robust reminder calls" as necessary. "At 8:55 AM, if a 9-AM patient isn't here yet, we call and check up and reschedule them as necessary," says Ma, estimating that 30%-40% of patients require robust reminders.

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