Implementation of a New Booking System to Reduce Unfulfilled Allied Health Appointments in a public pain unit: “NO SHOW,” NO GAIN!

Abstract

Unfulfilled outpatient appointments despite reminders by text message and/or phone calls continue to undermine the gains established by public pain units. A study was conducted to determine if the new booking process reduces the incidence of unfulfilled appointments and associated administrative burden for patients attending individual allied health (AH) appointments in a tier 2 public pain unit, while positively impacting billable clinical activity and wait times. This new system involves pre-emptive notification of a grace period, during which the patient can ring and reschedule their missed appointment; failing to do so will result in being placed at the bottom of the list for that clinician. Vulnerable patients, however, were duly reappointed. The impact of this new booking system was primarily studied in allied health clinics where non-attendance rates were high. A statistically significant reduction in NO SHOWs from 27.12% to 11.93% (p- value 0.0041), accompanied by an increase in billable clinical time from 39.3 minutes to 52.4 minutes (p-value 0.0009), was found. The number of mean administrative contacts required to book these appointments decreased from 1.4 to 1.15 (p-value 0.009), and a trend towards a reduction in wait times was observed, with an average waiting time of 191.97 days decreasing to 152.4 days (p-value 0.087). Thus, the new booking system effectively reduces non-attendance rates for allied health appointments in a public pain unit, despite a lack of readiness to change, without disadvantaging any chronic pain patient attending this clinic.