Appointment Scheduling

Appointment scheduling and templates are built to maximize provider’s productivity as well as utilize staffing appropriately. Currently, the third next available appointment reports have long wait times and the patients no show rates are consistently high for adult primary care clinics located in the Sarasota County Health Department. These high no show rates reduce the productivity of providers and reduce potential revenue. The long wait times are hindering the ability to meet performance goals that could be generating payment incentives for the chronic disease and the complex high acuity patients. In addition, we know that access to care is important for overall quality health delivery as well as disease prevention, detection, and screening.

Not wanting to hear bad news was one of the three reasons found by Lacy, Paulman, Reuter & Lovejoy (2004). Not understanding the scheduling process and feeling disrespected in the health care system were the other two reasons. The article reflected patients having to wait for appointments, wait to be seen and waiting in the exam rooms for providers were also perceived to be disrespectful. A retrospective study in primary care by Kaplan-Lewis and Percac-Lima (2103) found that no show rates are higher in underserved populations and that the patients simply forgetting was the most frequent reason for the no show. Kheirkhah, Feng, Travis, Tavakoli-Tabasi and Sharafkhaneh conducted a retrospective cohort study spanning from 1997-2008 comparing 10 clinics from primary care to subspecialty clinics. The goal was to evaluate economic consequences, predictors and prevalence. The authors presented a mean rate of 18.8% for no shows, the average cost of $196 for 2008. The article concluded with the data reflecting a major financial burden on the healthcare systems and women’s clinics with higher no show

Fiorillo, Hughes, I‐Chen, Westgate, Gal, Bush, & Comer (2018) found that there was an association and a 24% no show rate for new patient visit types in pediatric otolaryngology. While adult patients not showing for otolaryngology appointments tended to be younger aged females who had to wait longer for appointment dates (Cohen, Kaplan, Kraus, Rubinshtein & Vardy (2007). Menendez and Ring (2014) reported that an outpatient hand surgery clinic study found that their no-shows data were in the beginning of the week. Monday and Tuesday were the days with a higher prevalence of missing the appointment. While a pediatric otolaryngology practice found morning appointments and June to be the highest times for no shows (Huang, Ashraf, Gordish-Dressmand, Mudd (2017). Butterfield points out that younger men who are unmarried, and those patients living 19-60 miles away from the practice had higher no show rates (Butterfield, 2009). Dantas, Fleck, Cyrino & Hamacher (2018) reviewed over 105 in a systematic review of literature available and found that certain patient characteristics were identifiable overall. Younger age, lower income, no private insurance and living farther from the clinic has a more frequent no show association. Mehra, A., Hoogendoorn, C., Haggerty, G., Engelthaler, J., Gooden, S., Joseph, M., Carroll, S., Guiney, P. set out to when their patients were not showing and to apply interventions to reduce no