Researchers have suggested Imaging departments and centres look to the service industries for ideas on how to address missed appointments.
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Authors Jill Elizabeth Speece, of Atascadero, California-based Radiology Associates, and Kamran Eftekhari Shahroudi, PhD, of Woodward, Inc in Fort Collins, Colorado, said that missed appointments constituted a significant waste of healthcare resources.
In an article in the Journal of the American College of Radiology, the researchers pointed out a case where a medium-sized outpatient imaging centre lost close to $2mln in 2018 to ‘no shows’ or missed appointments.
Some absences were due to patients simply not turning up for their appointments; in other instances, patients phoned to cancel on the day. The centre ran experiments in order to reduce the number of same-day missed appointments with little success. Management started to look at possible solutions of best practices from service sectors to help alter patient behaviour.
Speece and Eftekhari suggested the following:
Flight carriers routinely overbook flights based on no-show trends. As passengers are required to pay for their tickets in advance, if too many turn up for a flight, airlines incentivise some to move to a flight which still has space. The study authors suggested radiologists consider using a similar double-booking approach.
Online reservations systems cancel diners’ accounts if they fail to show up for reservations multiple times and restaurants go to social media to ‘shame’ no-show customers. While researchers recognise this behaviour cannot be emulated in the same way in a medical environment, they suggested a tracking system of missed appointments with notifications to patients to highlight the inconvenient behaviour.
Companies usually offer the choice of paying in advance when booking or at vehicle pick up. “Pay now” is usually cheaper while “pay later” comes with charges such as fees for last-minute cancellations. Imaging departments could offer the option to pay later if a high out-of-pocket cost causes a patient to cancel an appointment on the day.
The accommodation industry implements pricing that rises and lowers in response to high and low seasons. Imaging practices could follow this responsive model by improving management of wait times to cut cancellations. They could do this by notifying ‘checked in’ patients how long they have to wait and by updating them.
While recognising that approaches and systems that work in one sector don’t always transfer to another, the authors did identify that human habits are at the core of the no show problem radiologists face. “It would be wrong to withhold a basic need from ‘bad patients.’ In healthcare, efforts to change the system are a better and more reliable option than trying to change patient behaviour,” they wrote.
Source: Radiology Business
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