We use a combination of communication through our electronic scheduling and medical record. If the patient is enrolled, they will receive a text 24 hours from the appointment asking them to respond yes to confirm or no to cancel. If they are not enrolled in the text messaging system, they receive a phone call reminder. Since implementation, no shows have significantly reduced in number.
I am not sure there is perfect percentage to be paid out for achieving metrics. The biggest issue in my mind is does it resonate with the physician? You can have the best metric in the world, but if it means little to the physician or seems arbitrary, it will not achieve the goal you want to achieve.
A challenging question indeed. The consensus seems to be improved quality and reduced complication for our patients is not only good for them, but is good for the organization in most cases regardless of the payment model. Focusing in quality and safety improvement should lead to success.
Another idea of how to incent the behavior desired is by showing improvement in things like recovery room delays, OR delays and floor delays by demonstrating how smoothing would benefit the surgeons and would reduce these delays. The frustration of an inefficient operating room is one of the greatest dissatisfiers for surgeons so improving these delays by aligning and smoothing the schedule and showing the surgeon how this benefits them may help change behavior.
To effectively function, the teams must be aligned. I agree with Dr. Smetherman’s suggestion around group production targets and removing incentives which lead to competition and disagreement within the groups. Also, it would be helpful to have regular transparent communications around the shared goals so each team felt comfortable with the contribution of the other groups.