The client managed a group of eight outpatient clinics. Executive management believed that revenue was being missed due to no-shows. The opportunity was suggested by the significant variation in no-show percentage among clinics.
Physicians were concerned about patient continuity. Missed appointments delayed needed treatments and caused higher total healthcare costs.
In addition, no-shows reduced the throughput of the clinic and created wasted time among staff. Additional wait time put the client at a competitive disadvantage.
Data on scheduled appointments showed that the no-show rate was proportional to the interval between the date the appointment was made and the date of appointment. That is, people scheduled for a same day or next day appointment were much more likely to “show” for an appointment than those scheduled 1-4 weeks or more in the future.
The clinic with the highest “no-show” rate wanted to improve, and was willing to try new solutions to improve patent continuity, have a more predictable workday and increase patient volume. They also hoped to reduce patient cycle time in the clinic.
A nine-person clinic work team composed of clinic physicians, consultants, and staff people were chosen to attack the problem. The team was responsible for:
Significant effort was devoted to working with the staff so that they understood the issues with the old system and could work with the new scheduling approach.
The team set up weekly metrics to capture visits and no-shows by time of day, revenues, and patient and staff satisfaction.
Clinic volume and patient gross revenue increased 5% and increased clinic net income by 3%. The project paid for itself in less than three months.
The clinic improved from the 13% no-show rate to 5% over the 12-week implementation period. The measured no-show rate declined while patient satisfaction and staff satisfaction improved.
The new schedule allowed more patients to be scheduled with their primary physician, thus leading to improved patient continuity and improved patient satisfaction.