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The patient access staff at an internal medicine practice are discussing a significant trend of no-show and canceled appointments. One receptionist stated that she was told by the coordinator to never schedule patients who call for same day appointments unless it is an emergency, such as medication reactions, so patients would value their appointments and discourage them from not showing up or canceling. The coordinator also indicated that the change was approved by the CEO. A receptionist became emotional and stated, “This is not right. We are here to help patients. Your plan does not seem to be working, and I think we should try something else.”
The coordinator then asked the staff how the patient recall list and the confirmation of appointments were managed. At this point, another receptionist indicated she thought the patient contact software was not working correctly. It was displaying confirmation icons for scheduled patients, but a few patients called to confirm their appointments on their own. She said, “We need to do something about this now and stop talking about it. I reported my suspicion several times to management but nothing was checked. I think patients calling to confirm their appointments is proof that the software does not work correctly.”
The coordinator continued to ignore the direct statements of the staff. Instead, she suggested she would study the relationship between patient gender, age, payer, and date appointments were set to determine if there were any patterns. “It’s about time you become involved in the solution,” a scheduler said. “Okay,” the coordinator said, “I am trying to solve this dilemma. We will accomplish nothing by complaining.” The first receptionist replied, “We will never solve the problem if you do not process our input.”
The coordinator smiled politely and nodded in agreement. In addition, everyone agreed that the data she would study could be helpful as a starting point. The coordinator further indicated she would have IT investigate issues with the patient contact software. A few days later, the coordinator met with all of the staff and shared her findings. Her finding revealed there was no relationship between date scheduled and canceled appointments or no-shows. She also indicated that IT found 893 patient portal messages unopened. The messages included requests to reschedule and text replies to cancel.
The group developed a consensus to follow the original scheduling protocol, which was patients are scheduled on a first call basis and the artificial barrier of two weeks was terminated. The coordinator accepted responsibility for the lack of follow-up on patient messages, but then assigned another scheduler the daily task of checking and responding to messages. The coordinator thanked everyone for their feedback, ideas, and support. She quipped, “Emotions are okay. Passion should be evident in all of us every day.”
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