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Research team to remedy patient no-shows

200,000 annual no-shows at Indianapolis Roudebush VAMC

Research team will redesign systems behind missed appointments

A multidisciplinary research team will help remedy the problem of patients missing medical appointments. Roudebush VAMC will be the laboratory for the research and intervention, with funding from the Veterans Health Administration.

“We have figured out that it costs us $78 every time a patient doesn’t show up for an appointment,” explains Roudebush Ambulatory Care Executive Peter Woodbridge. “We schedule 600,000 visits per year, and have 200,000 no-shows. Two hundred thousand no-shows times $78 gets to be very big money.”

Woodbridge says the opportunity cost of a patient missing an appointment is actually bigger and more important than the direct cost. “It’s a patient safety issue,” he says, “because when patients don’t show up for appointments we miss an opportunity to treat their illness.”

That’s why this research team refers to the problem as Missed Appointment Opportunities. Their plan is to reduce missed opportunities by redesigning the systems and processes behind patient visits.

With solutions in hand, the research team will plan and carry out an implementation, test the intervention, and guide its dissemination to other healthcare settings.

Members of the team will contribute to the project expertise in information technology, industrial engineering, systems design and simulation, organizational behavior and change, medical sociology, social psychology, implementation science, and clinical care. Their goal is to put in place an effective program that makes it easier for patients to keep their appointments.

Study title: Identification and Rapid Dissemination of Successful System Designs Addressing Missed Appointment Opportunities

Funding: A Quality Improvement Technical Assistance Project of four arms of the Department of Veterans Affairs: the Office of Quality and Performance, Advanced Clinical Access Program, Patient Care Services, and Health Services Research and Development Service.

Researchers: from the VA Center of Excellence in Implementing Evidence-Based Practice; IU Center for Health Services and Outcomes Research; Regenstrief Center for Healthcare Engineering (RCHE) at Purdue University; and Roudebush VAMC clinical experts.

Research team includes: Eri Kuno; Brad Doebbeling; Peter Woodbridge; Mindy Flanagan; Ranga Ramanujam; Richard Frankel; Steve Hare; Mark Lawley.

To learn more: contact Eri Kuno, PhD:ekuno@iupui.edu