Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study - 10/08/17
, David A. Lubarsky, MD, MBA a , Chaturani T. Ranasinghe, MD a , Constantine D. Sarantopoulos, MD a , Richard H. Epstein, MD b, ⁎ Abstract |
Study objective |
To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%.
Design |
Retrospective, observational study using electronic health records.
Setting |
Chronic pain clinic of an academic anesthesia department.
Patients |
All patients scheduled for evaluation or follow-up appointments in the chronic pain clinic between April 1, 2014, and December 31, 2015.
Interventions |
Open-access scheduling was instituted in April 2015 with appointments offered on a date of the patient's choosing ≥1 business day after calling, with no limit on the daily number of new patients.
Measurements |
Mean cancellation rates for new patients were compared between the 12-month baseline period prior to and for 7months after the change, following an intervening 2-month washout period. The method of batch means (by month) and the 2-sided Student t-test were used; P<0.01 required for significance.
Main results |
The new patient mean cancellation rate decreased from a baseline of 35.7% by 4.2% (95% confidence interval [CI] 1.4% to 6.9%; P=0.005); however, this failed to reach the 50% reduction target of 17.8%. Appointment lag time decreased by 4.7days (95% CI 2.3 to 7.0days, P<0.001) from 14.1days to 9.4days in the new patient group. More new patients were seen within 1week compared to baseline (50.6% versus 19.1%; P<0.0001). The mean number of new patient visits per month increased from 158.5 to 225.0 (P=0.0004). The cancellation rate and appointment lag times did not decrease for established patient visits, as expected because open-access scheduling was not implemented for this group.
Conclusions |
Access to care for new chronic pain patients improved with modified open-access scheduling. However, their mean cancellation rate only decreased from 35.7% to 31.5%, making this a marginally effective strategy to reduce cancellations.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Modified open-access scheduling was implemented for new patients at an academic chronic pain clinic. |
• | Appointments were offered on the date of the patient's choosing ≥1 business day after calling. |
• | The mean cancellation rate decreased from 35.7% to 31.5%, not meeting the target of a 50% reduction. |
• | Modified open-access scheduling was effective in increasing the number of patients seen. |
Keywords : Pain clinics, Appointments and schedules, Health services accessibility
Plan
Vol 41
P. 92-96 - septembre 2017 Retour au numéro
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