No Shows: Effectiveness of Termination Policy and Review of Best Practices

...........................................................................................................................................3 Introduction ......................................................................................................................................4 Statement of Purpose .......................................................................................................................6 Literature Review.............................................................................................................................6 Methods..........................................................................................................................................13 Results ............................................................................................................................................17 Discussion ......................................................................................................................................23 References ......................................................................................................................................27 Appendices .....................................................................................................................................32 NO SHOWS: TERMINATION POLICY AND BEST PRACTICES 3 Abstract The primary objective of the study was to identify whether the implementation of Patient No Show and Termination policy at Five Rivers Health Centers (FRHC) is associated with a significant reduction of its no show rate. The secondary objective was to perform the best practices review on other strategies to reduce no shows. The data for this study was obtained retrospectively from the electronic medical records of the seven clinical centers of FRHC. Individual clinic's no show rates and cumulative no show rates for pre-implementation and postimplementation period were calculated. Chi-squared test were used to detect statistical significance between preand post-implementation period. The best practices review was performed using peer reviewed research studies (studies conducted in US and published between 1990 and 2013). The analysis found that the aggregate no show rate of FRHC clinics decreased during the post policy period and the difference was a decrease of 10% (p<0 .001). The individual clinic's analysis showed there was statistically significant reduction in no show rates of four clinics: FRHC Center for Women Health, FRHC Family Practice, FRHC Primary Care Ludlow, and FRHC Specialty Clinic Apple. The best practices review suggests that telephone, mail, exit interview, open access scheduling all improved attendance at a moderate rate. When considering the technology penetration and efficacy, telephone reminder proves to be a goodThe primary objective of the study was to identify whether the implementation of Patient No Show and Termination policy at Five Rivers Health Centers (FRHC) is associated with a significant reduction of its no show rate. The secondary objective was to perform the best practices review on other strategies to reduce no shows. The data for this study was obtained retrospectively from the electronic medical records of the seven clinical centers of FRHC. Individual clinic's no show rates and cumulative no show rates for pre-implementation and postimplementation period were calculated. Chi-squared test were used to detect statistical significance between preand post-implementation period. The best practices review was performed using peer reviewed research studies (studies conducted in US and published between 1990 and 2013). The analysis found that the aggregate no show rate of FRHC clinics decreased during the post policy period and the difference was a decrease of 10% (p<0 .001). The individual clinic's analysis showed there was statistically significant reduction in no show rates of four clinics: FRHC Center for Women Health, FRHC Family Practice, FRHC Primary Care Ludlow, and FRHC Specialty Clinic Apple. The best practices review suggests that telephone, mail, exit interview, open access scheduling all improved attendance at a moderate rate. When considering the technology penetration and efficacy, telephone reminder proves to be a good mode of appointment reminder strategy.