Stock Keister, Mary, MD

Torres, Sheyla M, LPN

Wida, Sarah K

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Department of Family Medicine Are No-Show Rates Impacted When Automated Reminder Calls Feature a Clinician’s Voice? Mary Stock Keister MD Sheyla M. Torres LPN Sarah K. Wida Follow this and additional works at: https://scholarlyworks.lvhn.org/family-medicine This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. © 2019 Lehigh Valley Health NetworkLVHN.orgAre No-Show Rates Impacted  When Automated Reminder Calls Feature a Clinician’s Voice?Mary Stock Keister, MD, Sheyla Torres, LPN, Practice Director, Sarah Wida, Operations ManagerLehigh Valley Health Network, Allentown, Pa.BackgroundNo show rates at LVPG- Family Health Center, a family medicine residency clinic, had an average no-show rate of 24% for FY 19. There are concerns from residents, especially at the start of their PG1 year, that low outpatient volume due to no-shows adversely impacts their education. With faculty changing to an RVU based comp model, there is concern regarding ability to meet contractual obligations with this rate. On literature review, previous works have identified barriers such as: “participants did not feel obligated to keep a scheduled appointment in part because they felt disrespected by the health care system. The effect of this feeling was compounded by participants’ lack of understanding of the scheduling system.”1One third of residency clinics have no-show rates that exceed 20% despite use of reminder systems.1All but 2 practices (in another study) attempted to contact all patients within 24 to 48 hours of every appointment to remind them of the appointment. One practice administrator reported that “when a secretary, who had been telephoning all of the patients the day before their appointment, decided to stop doing so (without telling her supervisors), the no-show rate went from 5% to 10% within 1 week.”2Logistic regression analysis found no significant relationship between  no-show rates and free-text reports of telephoning to remind all  patients, open-access scheduling, or patient dismissal for no-shows.2The Family Health Center has a no-show policy, rolled out on May 19, 2019, which accounts for patient notification, telephone contact on same or next business day for all no-shows, documentation and tracking of no-shows, notification of PCP after 2 no-shows, recommendation to dismiss after  3 no-shows within 6 months. This intervention decreased no-show rate from 23% to 20%. An automated appointment reminder system has  been in place for years, utilizing a standard, computer generated voice.InterventionTwo physicians in the office volunteered to be recorded into  the Televox system so patients would hear a doctor’s voice, rather than a computer generated voice, on their reminder call. Recordings were made in English and Spanish. Physician voice recordings took approximately 60 minutes to perform to capture all data points to be used in the Televox system. There were several issues with recording and several re-recording sessions had to take place for individual elements. Go-Live for  the new reminders was 10/18/19. References1  Why We Don’t Come: Patient Perceptions on No-Shows. Naomi L. Lacy, PhD, Audrey Paulman, MD, MMM, Matthew D. Reuter, BA, and Bruce Lovejoy, MSN, APRN, FNP-C. Ann Fam Med. 2004 Nov; 2(6): 541–545.2  Reduction and Management of No-Shows by Family Medicine Residency Practice Exemplars. Bradley J. Johnson, MD, James W. Mold, MD, MPH, and J. Michael Pontious, MD. Ann Fam Med. 2007 Nov; 5(6): 534–539Results2 weeks after Go-Live, both MSK and MG saw reductions in No-Show rates while control clinicians  JS and JM saw no such reduction.NO SHOW RATE MSK MG JS JMFY19  Individual Average 23.80% 21.98% 26.62% 25.29%FY20 YTD  Individual Average 20.22% 20.31% 27.64% 20.80%July 2019 15% 18% 23% 17%Aug. 2019 20% 19% 20% 21%Sept. 2019 14% 14% 22% 15%Oct. 2019 21% 20% 29% 20%Oct. 1–16, 2019 24% 23% 26% 13%Oct. 17–31, 2019 17% 16% 32% 24% Nov. 1–15, 2019 16% 19% 27% 26%Rates remain within the variation expected for the year. Rates are reviewed every 2 weeks.DiscussionOptimal education and maintaining a robust community clinic presence requires patients to show up. While technology can make patient reminder systems less cumbersome on office staff, they also remove the personal connection which patients say they want in their primary care offices. Combining the personal  with the technological may help enhance the caring, relational aspect of the patient visit. There is an initial investment of clinician and admin time in collecting  and reviewing the recordings. left: Examples of recordable elements in Televox

Are No-Show Rates Impacted When Automated Reminder Calls Feature a Clinician’s Voice?

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1646&context=family-medicine

Are No-Show Rates Impacted When Automated Reminder Calls Feature a Clinician’s Voice?

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