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 7 months 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 4.7 days (95% CI 2.3 to 7.0 days, P < 0.001) from 14.1 days to 9.4 days in the new patient group. More new patients were seen within 1 week 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 92-96 |
| Number of pages | 5 |
| Journal | Journal of Clinical Anesthesia |
| Volume | 41 |
| DOIs | |
| State | Published - Sep 1 2017 |
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Keywords
- Appointments and schedules
- Health services accessibility
- Pain clinics
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
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. / Sivanesan, Eellan; Lubarsky, David; Ranasinghe, Chaturani; Sarantopoulos, Konstantinos D.; Epstein, Richard H.
In: Journal of Clinical Anesthesia, Vol. 41, 01.09.2017, p. 92-96.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - 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
T2 - A retrospective, observational study
AU - Sivanesan, Eellan
AU - Lubarsky, David
AU - Ranasinghe, Chaturani
AU - Sarantopoulos, Konstantinos D.
AU - Epstein, Richard H.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - 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 7 months 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 4.7 days (95% CI 2.3 to 7.0 days, P < 0.001) from 14.1 days to 9.4 days in the new patient group. More new patients were seen within 1 week 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.
AB - 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 7 months 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 4.7 days (95% CI 2.3 to 7.0 days, P < 0.001) from 14.1 days to 9.4 days in the new patient group. More new patients were seen within 1 week 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.
KW - Appointments and schedules
KW - Health services accessibility
KW - Pain clinics
UR - http://www.scopus.com/inward/record.url?scp=85024093352&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85024093352&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2017.06.003
DO - 10.1016/j.jclinane.2017.06.003
M3 - Article
VL - 41
SP - 92
EP - 96
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
SN - 0952-8180
ER -