The Reading Room

Struggling with no-shows in radiology? Here's what you should do about it.

by Lea Halim and Catherine Kosse

No-show visits (NSVs) are a constant challenge for imaging departments, resulting in financial losses and delays to patient care. Programs have long tried to track no-show trends, but what if you could accurately predict skipped appointments with existing data?

A new study from the Journal of the American College of Radiology solves this challenge by leveraging EHR data to predict at-risk patients. In this study, researchers from Massachusetts General Hospital analyzed over 54,000 radiology appointments at a large academic medical center (AMC) and identified three risk factors for NSVs:

  • Previous no-shows in the past year
  • Appointments scheduled two days or more prior to exam
  • Mammography or CT appointments

Overall, the study found 6.5% of appointments to be no-shows. This is similar to what we heard from Imaging Performance Partnership members, that 5.5% of appointments are NSVs.

What can imaging leaders do? While there is no way to completely eliminate NSVs, there are some concrete steps imaging programs can take to decrease their frequency and impact.

Improve patient engagement and scheduling strategies for at-risk patients

Analyze your scheduled imaging patients to pinpoint at-risk individuals (those with at least one NSV risk factor identified above). Then, target your patient engagement and scheduling strategies to reduce the risk and effects of these no-shows. For example:

Increase the frequency of appointment reminders. Patients likely to skip a diagnostic imaging appointment should receive additional reminders in the days leading up to the exam. The Massachusetts General Hospital researchers found that increased text message reminders correlates with reduced NSVs for at-risk patients.

Decrease wait time for late arrivals. Make sure a skipped appointment doesn't wreak havoc on your schedule by asking receptionists to decrease the amount of time held for late patients identified as at-risk. For example, if you typically wait 15 minutes for late patients, decrease the time frame to 10 minutes for at-risk patients. This allows you to move on to other patients and avoid cascading delays caused by predictable skipped appointments.  

Decrease impact of no-show visits for all imaging patients

Beyond working with patients at highest risk for no-shows, there are additional strategies imaging programs can use to reduce all NSVs, as well as reduce care delays and financial impacts after the missed appointment.

Create a no-show coordinator. This staff member should be responsible for rescheduling all no-show appointments. At Baptist Health South Florida, the coordinator reviews daily no-show reports and reschedules appointments in a timely manner to prevent further care delays. Learn more about this coordinator on page 24 of our research report, "Streamlining Imaging Access."

Use our No-Show Analysis Worksheet. This tool allows you to analyze no-show trends beyond the predictors found in the EHR. Use this monthly to identify ways to minimize the impact of no-shows.

 

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