Tuesday, June 24, 2008

No Shows

Like most offices we suffer from occasional no shows. I decided to take a harder look at when and why they occur. We use the typical techniques to try and minimize the problem. We give an appointment card at the time the appointment is booked, we advance confirm (weeks ahead), immediately confirm (days ahead) and occasionally charge for no shows. We also try to have a single point of contact for regular patients (e.g. they deal with one front desk person).

Oddly, we do not see seasonal variation to no shows. Nor do we see a change to no shows when the point of contact for the patient is changed. I have posted no show rates for one doctor, one office below.

When looking at the data retrospectively the arrows indicate points immediately before we added staff to the front desk. Based on this data, the productivity of the front desk appears to be a significant factor in our no show rate. Just before we have to hire additional administrative staff due to growth the no show rate is greater than 1 standard deviation above the average. In other words, when the front desk is working at 110% capacity, no shows increase. Immediately following expansion the no show rate dips. In early June '07 our office moved into a large larger facility. We had an immediate increase in the number of appointments without an increase in the number of front desk staff. The mis-match was corrected within 3 months but the temporary result is obvious.

The no show rate of your office may be a symptom of a much larger problem (namely over-worked staff) rather than inconsiderate patients. Rather than looking to patient factors first look at metrics that measure staff productivity such as call-answer rates, on-hold time, patient encounters/front desk.

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