Best practice

Model reduces no-shows, increases patient visits

Interventions to address patient challenges make big impact on bottom line, according to JAOA study.


Elmont Teaching Health Center (ETHC), a community-based health center in Long Island, New York, realized a 34 percent decrease in patient no-show rates in the fourth quarter of 2015, according to a study published in the February issue of The Journal of the American Osteopathic Association.

A patient survey in the third quarter of 2015 helped ETHC to understand the primary reasons why patients did not show up for their appointments.

“The primary reasons were simply forgetting the appointment, being called in to work, or not being able to reach someone at the center or leave a voicemail to cancel,” says Peter Guiney, DO, chairman of the  Department of Family Medicine at Nassau University Medical Center.

No-shows common, costly

Recent studies have found no-show rates in outpatient settings range between 23.1 and 33.6 percent and result in decreased efficiency, lost time, and higher use of resources. Patient no-shows consume 14 percent of anticipated daily revenue for clinics and can result in longer wait times, a lower quality of care, worse health outcomes, and lower patient satisfaction.

Research shows that patients who typically don’t show for appointments tend to be younger, have a lower socioeconomic status, are less likely to understand the purpose of their appointment, and have a history of failed appointments.

A multi-faceted solution

Dr. Guiney notes that many external factors in the patients’ lives contributed to no-show rates; however, ETHC found improvements they could make within their organization. He adds, “We designed an intervention to address every road block that was within our control.”

ETHC implemented a series of interventions, including:

  • Reminder calls to the patient the day prior to the appointment
  • Patient education on the importance of complying with appointments
  • Routing calls to all front-desk staff in an effort to answer every incoming call
  • Sending weekly reports on no-show rates to staff and celebrating reductions
  • Using gaps from no-shows to accommodate patients with immediate needs

Dr. Guiney says ETHC’s patient visits were up 13 percent during the study period, which he says underscores the efficacy of the interventions.

Researchers hope the findings can serve as a model to help other outpatient clinics reduce their no-show rates.

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