Friday, November 30, 2018

Physician Offices and the No-Show Rate

This week, I had the pleasure of going on the GBMC Health Partners Lean Daily Management walk. I, along with members of my team, visited our Neurology Center, Ophthalmology, and Bariatric Surgery practices. I was so excited to see the incredible level of engagement of the staff in each practice. They are doing phenomenal improvement work to move us faster towards our vision!

In the Neurology Center, Kristen Stamathis, the Senior Practice Manager, presented a least waste metric. The team was working to better understand the causes of patients not coming for their appointment and how to reduce this “no-show” rate. Dr. Michael Sellman, the Medical Director, and Kristen know that the time neurologists spend with their patients is an incredibly valuable resource. With the aging of the population, there is an ever-increasing need for neurology consultations and there are very few neurologists in our community.

Literature suggests that the patient no-show rate goes up exponentially for appointments made more than 18 days before the date of their visit. People are more likely to forget about the appointment or have their needs met in some other way the more distant the scheduling date is from the appointment date. I pointed out that many restaurants will not allow you to make a reservation more than 30 days in advance because of this fact.

So, what should the team do to make sure appointments are not wasted? I told the group that my dentist texts me the day before the appointment and asks me to respond “Y” for yes if I can keep my appointment or “N” for no if I can’t. If I reply “no” or don’t reply at all, they give my appointment to another patient. For many restaurants that use OpenTable, I now get a prompt the day before asking me to confirm my reservation. We also discussed the commercial airline system where they calculate the average no-show rate and overbook the seats. They know that sometimes everyone will show up and then they must pay some passengers to fly later (Kristen and Dr. Sellman didn’t like the idea of paying some patients to come back another day…okay, I was only kidding) but by doing this, the airlines ensure that they won’t take off with empty seats from no-shows.

Of course, no reminder system is foolproof, but I was very proud of the team for the rigor of their study of the problem and their willingness to test new ideas.   

A huge “Thank You” to our Elder Medical Care team!!!
Last week, our Elder Medical Care (EMC) Home Services Team provided Thanksgiving dinner to families in need. Last year, we helped 10 families enjoy their Thanksgiving Day holiday, but this year, the need was greater than ever, and our program rose to the occasion.

Thanks to the efforts of our EMC Home Services Team and the Notre Dame University of Maryland pharmacy students, 15 turkeys and more than $400 in cash and gift cards helped to provide a very nice Thanksgiving Day meal to two small assisted living facilities (ALF) -- the donation to Agape ALF was made in honor of Kathy Ruane -- and 15 families. The Thanksgiving dinners consisted of turkeys or rotisserie chickens, side dishes, bread, and dessert. Some of our families, who are not able to cook due to safety concerns, received ready to eat or microwavable meals. Providing families with a Thanksgiving meal who would otherwise not have had one is an all-hands-on-deck effort lead by the providers of the EMC Home Services Team.

A big thank you to Laurie Whelden, Yolanda Greene, Jessica Trizna, Asma Hussaini, and Dr. Freedman for helping with the deliveries, to Thelma Winn for picking up our donations from the Assistance Center of Towson Churches, Kathy Roberts for delivering frozen and fresh poultry around Baltimore County, and to the EMC/Advanced Care Management employees who donated their frozen turkeys and canned goods/money. We could not have done this without all of you and I am truly thankful for your kindness and generosity!

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