Overbooking Increases Patient Access at East Carolina University's Student Health Services Clinic

The health-care clinic presented in this study experienced significant numbers of patients who failed to arrive for their scheduled appointments (no-shows). The cost of reducing patient access at this clinic because of noshows is estimated to exceed $400,000 annually. An interdisciplinary quality-improvement team developed a novel health-care overbooking model that includes the effects of employee burnout. This model estimates the nonlinear nature of the costs associated with medical-provider burnout caused by overbooked appointments that exceed clinic capacity. Several key East Carolina University clinical staff members had been skeptical about the value of overbooking. The model was instrumental in convincing them that implementing an overbooking process would benefit patients and the organization. The clinic, which subsequently implemented such a process, attributes a savings of $95,000 per semester to the initiative.