Unfilled Slots: Tackling Non-Arrivals - Part 2

In Part 1, we discussed the importance of gathering and assessing business intelligence, and we're continuing the conversation with determining prevention strategies.

Determine Prevention Strategies. Many health systems skip over this step, but preventing non-arrivals is an essential part of the discourse. First, incorporating interventions engages all stakeholders. As a health system, the mission is to provide care. If an appointment is granted, it is our duty to serve that patient.  Leading with the discourse about best-practice, patient-centered interventions provides a framework to engage everyone in this important discussion.

Next, using business intelligence as a guide, stakeholders can work on intervention strategies. Providers can be reminded as to the importance of communicating with the patient (and, as applicable, families or caregivers) about the subsequent appointment – and the significance of attending it. This discourse is an essential component of the encounter’s closure – and it’s remarkably often missed.

Steps may be taken to communicate with all patients to remind them of their appointments at a designated cadence (for example, 7, 3, and day-prior text); further efforts may include identifying certain patients (based on their non-arrival probability and/or social determinants of health) to supplement with calls from clinic staff.

Stakeholders may also determine strategies - such as offering telemedicine visits as an alternative to in-person encounters - to patients who express their intention to not arrive. These efforts must incorporate a detailed action plan - for example, how will patients be identified for intervention? Who is responsible for intervening? What are the intervention efforts? How will the efforts be documented? Etc. The legal aspects should not be overlooked during this stage; this may include but not be limited to the documentation efforts, charging patients (if applicable), and terminating patients from the practice for a history of failure to show.

A special thanks to Chris Profeta for his contributions to this article.