Friday, September 19, 2008

Summer Wrap-Up

Last week, at our team meeting, we cleaned up the aftermath of the summer. Doctors' holidays make it challenging to keep up with our backlog. Last summer, we saw our 3rd NAA times creep up. In the early part of this summer, the numbers were looking good, and we thought we'd changed the system enough that the wait wouldn't grow, despite reduced capacity.

No such luck. Our latest 3rd NAA is up to 60 days. Here's hoping that the end of summer holidays signals an improvement here.

There is some brighter news. Last post, I looked at our patient-recall patterns. We've got data from May to August now, and there's still a striking variation among urologists in the rate at which we recall our patients for review. Here are the average recall rates:



Here's the promising part:



Over the summer, we've been raising awareness of recall practices. Perhaps this has started to change some habits. If this downward trend in recall rates continues, we'll increase our capacity.

Also at our latest team meeting, we decided to streamline data collection. Our staff has been tracking several measures that aren't needed as frequently.

Measurement
Current status
Future plan
Referral numbers
Recording all referrals
One week per month
No-show rate
Weekly
One week per month
3rd NAA
Weekly
No change
Out of town referrals
Discontinue recording
Backlog
Weekly
No change
Recalls
Weekly
No change

"Calling all patients" reported our efforts to reduce no-shows. Amanda et al have continued to work on this. We know that phoning all patients to remind them of upcoming appointments drops our no-show rate significantly. But, calling every patient is a lot of work for our staff. The latest trial compared 3 interventions during the same 4-week period.

Intervention
No-show rate (%)
No patient reminder
16.25
All patients reminded
5.54
New patients reminded
5.87

Calling new patients is the most effective intervention (balancing effort and effect), so we’ll make that our standard procedure. Every bit of saved capacity helps!

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