Ref­er­ences re­quired

East­ern Health im­ple­ment­ing new pol­icy for ‘no shows’

The Compass - - EDITORIAL - TC ME­DIA The Tele­gram

East­ern Health is im­ple­ment­ing a new pol­icy, ef­fec­tive Nov. 28, to ad­dress a high num­ber of “no shows” to its adult am­bu­la­tory clin­ics and di­ag­nos­tic imag­ing ap­point­ments.

Pa­tients who miss an ap­point­ment - or who don’t can­cel with suf­fi­cient no­tice of 48 hours - will be re­quired to ob­tain another re­fer­ral let­ter from their physi­cian in or­der to be given a new ap­point­ment.

The health au­thor­ity said in a news re­lease about 1.6 mil­lion ap­point­ments are sched­uled ev­ery year at its adult am­bu­la­tory clin­ics, some­times re­ferred to as out­pa­tient spe­cialty clin­ics. They in­clude a va­ri­ety of pro­gram ar­eas, such as en­doscopy, ortho­pe­dics, di­a­betes, and physi­cian ap­point­ments, among oth­ers.

Statis­tics for 2015 - 2016 in­di­cate that an av­er­age 11 per cent of pa­tients ei­ther didn’t show up for their ap­point­ments or did not can­cel them with suf­fi­cient no­tice. This equates to 176,000 missed ap­point­ments.

In some clin­i­cal ar­eas, such as the out­pa­tient spe­cialty clin­ics at the Health Sciences Cen­tre, East­ern Health said the num­ber of an­nual “no shows” has reached as high as 5,000 in re­cent years.

David Di­a­mond, pres­i­dent and CEO of East­ern Health, said “no shows” have a “sig­nif­i­cant” im­pact on both the or­ga­ni­za­tion’s re­sources and its wait lists.

“When a per­son doesn’t show at the ap­pointed time, or doesn’t give suf­fi­cient no­tice, there is no time to of­fer that ap­point­ment to some­one else, re­sult­ing in wasted re­sources of both staff and equip­ment.”

Ad­di­tion­ally, Di­a­mond said, the “no show” pa­tient usu­ally needs to be re­booked, which slows down the book­ing/ap­point­ment process over­all. “Most im­por­tantly, it means a de­lay or lost op­por­tu­nity for oth­ers on our clin­i­cal wait lists, who need to be seen sooner, rather than later.”

East­ern Health book­ing staff will make al­lowances for ex­ten­u­at­ing cir­cum­stances such as fam­ily emer­gen­cies, se­vere ill­ness, a death in the fam­ily or se­vere weather con­di­tions such as bliz­zards or hur­ri­canes whereby weather warn­ings have been is­sued and/or non­emer­gency ser­vices have been can­celled.

In such cases, or with suf­fi­cient no­tice, East­ern Health said in its news re­lease, the ap­point­ment would be re­booked with­out a new re­fer­ral, on a one-time ba­sis only.

A province-wide pi­lot project is also ex­pected to re­duce the num­ber of “no shows” to clin­i­cal ap­point­ments. An au­to­mated no­ti­fi­ca­tion sys­tem (ANS) is be­ing pi­loted in the 12 En­doscopy Ser­vices De­part­ments through­out the four re­gional health au­thor­i­ties.

Launched at East­ern Health on Nov. 9, its pa­tients will now be no­ti­fied by phone seven days prior to an en­doscopy ap­point­ment, so that they may ei­ther con­firm their ap­point­ment and make any re­quired prepa­ra­tions, or can­cel the ap­point­ment, al­low­ing other pa­tients to be booked in any un­filled ap­point­ment slots.

East­ern Health said it is also mov­ing for­ward with plans to ex­pand no­ti­fi­ca­tions to text and email op­tions.

De­layed ac­cess to spe­cial­ist clin­ics and other out­pa­tient ser­vices be­cause of ‘ no shows’ can af­fect pa­tient out­comes and in­flu­ence de­mands on other parts of the health­care sys­tem, said Elizabeth Kennedy, re­gional direc­tor of am­bu­la­tory clin­ics.

“Our pri­or­ity is to pro­vide ac­cess to clin­i­cal care as quickly as pos­si­ble, and to re­duce the cost of a missed ap­point­ment, not just in terms of or­ga­ni­za­tional ef­fi­ciency, but in terms of pos­si­ble med­i­cal out­comes,” Kennedy said. “We un­der­stand that missed ap­point­ments are un­avoid­able at times; how­ever, we need the pub­lic to part­ner with us to make the ap­point­ment process more ac­ces­si­ble and fair for all.”

In­for­ma­tion on the new pol­icy can be ac­cessed on East­ern Health’s web­site at http:// www. east­ern­health. ca/ OurSer­vices. aspx?d=2&id=2313&p=202

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