Turning Appointment No-Shows Into a Hospital-Wide Benefit

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Nova Scotia Health Authority Turns Patient Appointment No-Shows Into a Hospital-Wide Benefit

Nova Scotia Health Authority, previously Capital Health, is Nova Scotia’s province-wide provider of health services. They operate hospitals, health centers, and community-based programs throughout the province. Nova Scotia Health Authority is the province’s largest employer with more than 23,000 employees and 7,000 volunteers, providing medical and surgical care, mental health care, community health programs, addiction prevention and treatment, and environmental health services.

Nova Scotia Health Authority partners with community groups, foundations, governments, schools, and others to host wellness programs in the community, as well as educate tomorrow’s health care providers and administrators, and engages in research into new treatments, cures, processes and practices.

Medical Appointment Reminder Software

Each day, thousands of Nova Scotia Health Authority patients have scheduled appointments. Years ago, patients received reminders about upcoming appointments only occasionally, because staff would make calls from a list when they weren’t helping people face-to-face.

When a patient doesn’t show up for a scheduled appointment, a number of things happen. There is a loss of services for the nurses, doctors, and technologists scheduled to work with that patient, a loss of services for equipment needed for that patient, and the patient has to be rescheduled, or in some cases, put on a wait list.

The Nova Scotia Breast Screening Program realized the value of reminding patients about their upcoming appointments, and approached the Capital Health/Nova Scotia Health Authority’s call center to help them make reminder calls. The call center agreed to help using a manual process, at first, to track the results.

The appointment reminder calls made such a substantial impact that Capital Health/Nova Scotia Health Authority soon saw the need for an automated system, and selected the 1Call Automated Appointment Reminder software solution.

Reducing No-Shows

Once the solution was in place, the no-show rate dropped from 9 percent to 1 percent, and their average wait list dropped from 9 months to 3 months.

When the software was initially installed, Natalie Klaus, Senior Manager of IT commented, “We currently process approximately 11,000 automated calls per month, which is maybe 1 percent of the total number of appointment reminder calls.” Betty Bouchie, Senior Systems Analyst (now retired) added, “The second that the word got out of the impact we had made with 1Call’s medical appointment reminders, we had people lined up down the block. Everyone wanted the same thing.”

Call center staff learned several key things about appointment reminders. They discovered that calling three days before the appointment is optimal. Four to five days is too long and the patients forget about it, but any less than three days is too late, and they may not reach the patient. They also found that using a unique Caller ID number for each department or group makes it more likely that people will answer the call.

Each patient appointment is set up to try as many as six times, to leave a reminder message; twice each day, morning and evening for three days before the appointment. They’ve found that they typically reach the patient on the first call.

Customizable Appointment Reminder Messages

The appointment reminder messages that patients hear are customized, depending on the specific needs of the department or group. They have included important reminders, such as a facility being “scent-free,” and also reminders that the patient should arrive 15 minutes before their appointment time.

Each group also has a unique callback number if patients need to reach them. The appointment reminder software does a lookup to determine if the number called is local. If it is, then it provides a local callback number. If the number called is long distance, the software provides a long-distance callback number.

Hospital-Wide Benefits

Another benefit of the automation is freeing up staff. According to Natalie, “It’s mainly the no-show rate, but it’s also about redeploying current resources to do other tasks. So, if you had a person assigned to make calls all day, now you can have them complete other tasks.”

An unexpected benefit of appointment reminder calls is related to the wait list. Because patients get the reminders in advance, if they do need to cancel, they can call to reschedule, and then a person from the wait list can be placed in that appointment. Since the appointment time can be scheduled with a wait list patient, it is not lost on a no-show who would then also need to be added to the wait list.

The appointment reminder software even improved automated data importing. Nova Scotia Health Authority receives different types of data from various groups, which is converted into the appointment reminder database. The process is automated, and is scheduled every night. Data is imported five days in advance, so if a problem does occur receiving the data, several people are alerted via e‑mail. When this happens, the cause can be investigated and fixed before there is any impact to the reminder calls.

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