Unfilled Slots: Tackling Non-Arrivals - Part 3

In Part 1, we discussed the importance of gathering and assessing business intelligence, and in Part 2, we learned how to determine prevention strategies. Now, in Part 3, we'll discuss managing the templates.

Manage the Templates. The scheduling template provides an exceptional tool to manage non-arrivals, as they will exist despite all best efforts to prevent them. The issue of non-arrivals is, at its foundation, one of human behavior. Predictive (or strategic) booking is the final pillar to address non-arrivals. Efforts can simply feature overbooking by the number of slots that are, on average, predictably failing to show. For example, if a clinic with 100 slots per week exhibits a consistent show rate of 90%, an additional 10 slots can be built into the template for a total of 110. This overbooking tactic, driven by the "average" experience, however, often fails to engage constituents in a positive manner. In sum, providers and clinic staff quickly become frustrated with the booking strategy and rebel. The reaction is understandable as human behavior doesn't
align with a strategy tied to an "average."

A more refined approach would be looking at the predictability of non-arrivals based on weeks of the year, days of the week, hours of the day, or (ideally) slots – and strategically overbook the schedule accordingly. For example, summer months may be slower, as vacations propel low volumes – or perhaps the opposite effect is in play; Mondays are often days with add-ons, but Thursdays may historically be a low-volume day; alternatively, early-mornings may be the perfect opportunity for an extra appointment for some practices, while others find the late afternoon to work best. The best solutions are driven by data and team engagement.

Efforts to strategically overbook slots can be supplemented (or replaced) with additional tactics like a robust waitlist – ideally automated - to combat cancellations close to the appointment date. This action leverages patients who have self-selected into a desire for a sooner appointment, helping to replace cancelled slots. Further, consider establishing a separate template for Dr. No-Show, on which to place patients with a history of non-arrivals. Should a "Dr. No-Show" patient arrive, the providers would either be on call for the patient - or rotate as to who sees the patient. Either way, these likely-to-not-arrive patients would still be granted access, but not cannibalize the appointment schedule. Creative solutions may be in order; consider, for example, some small token – like a chit for complimentary parking or coffee – for patients who have arrived without fail during a treatment course or over a designated period of time, noting that this “reward” solution would need to be vetted by your legal team.

To be effective, strategic booking must be informed by business intelligence and performed at a local level (specialty, subspecialty or even clinic), as each practice has nuances related to slot utilization that must be accounted for when managing templates.Once stakeholders come together at the table to solve the non-arrival problem collectively, we can be more effective at addressing unfilled slots.

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