Administration of Patient No-Shows in Family Practice Residency Programs

Presentation Transcript

Administration of Patient No-Shows in Family Practice Residency Programs Bradley Johnson, MSIII James Mold, M.D., M.P.H. Michael Pontious, M.D.

Research Question What is the most ideal approach to diminish no-appears in residency centers? What it the most ideal approach to deal with no-demonstrates that do happen?

Methods Survey executives of all U.S. family rehearse residency centers Find praiseworthy facilities for each of the two stages/segments Interview (telephone) therapeutic chiefs/directors of model centers Identify a consolidated "best" strategy for dealing with no-appears

Methods Definition of "best" strategies Clinics with the most reduced no-demonstrate rates for occupant arrangements (<10%) 2) Clinics seeing 8-10 patients/inhabitant/half day and a fulfillment level of 4-5 for current administration procedure

Methods Survey Instrument Clinic socioeconomics Average number of visits/half day/inhabitant for: built up patients new patients no-appears

Methods Perception of no-show issue Satisfaction with current techniques Current techniques being used Impact of no-shows

Results

Results

Perceived No-Show Impact

Visits per Half Day per Resident

Frequency of No-Show Rates Mean 20.5%

Correlations No connection between's no-indicate rates and fulfillment with no-demonstrate rates No relationship between's no-demonstrate rates and rate of Medicaid patients Negative relationship between's no-demonstrate rate and number of patients seen/half-day Positive relationship between's number of patients seen/half-day and fulfillment with administration of no-shows once they have happened

Top 10 Clinics for No-Show Rate No-Show Rate - Range: 3 - 9% - Mean: 6.3% Satisfaction with Method to Reduce No-demonstrates - Range: 1 - 5 - Mean: 3 Prevention Method 7 - update calls to all patients 1 - update calls to issue patients just 1 – nothing

Bottom 10 Clinics for No-Show Rate No-Show Rate - Range: 33 - 57% - Mean: 43.3% Satisfaction with Method to Reduce No-indicates - Range: 1 - 4 - Mean: 2.3 Prevention Method 4 - update calls to patients 2-now and again make update calls to patients 2 - tolerant instruction 1 - update letter 1-letter 10 days, call 1& 2 days before

Top 10 Clinics for Visits/half day of 8-10 and No-Show Management Satisfaction of 4 or 5 No-Show Rate - Range: 10-30% - Mean: 14.6% Management Method 3 - load with walk-ins 1 – overbook (3 - send cautioning letters, reject from practice after 3 no-indicates 3 - send letters)

Bottom 10 Clinics for Visits/half day of 8-10 and No-Show Management Satisfaction of 1 or 2 No-Show Rate - Range: 12-38% - Mean: 12.8% Management Method (3 - send letters 2 - send cautioning letters, perhaps expel from practice after 3 no-demonstrates 2 - nothing 1 - send letters, after 3 no-indicates persistent made a request to come in at end of timetable and is worked in 1 - understanding training)

Interviews to Date 4 Interviews with administrators of facilities with low no-indicate rates 1 really has rate of 14-15% (precluded) The other 3 call EVERY patient the day preceding, record ALL no-shows and cancelations in diagram; send approach letter after first no-appear; expel patients after 3 consecutively