Intake hours your new patients keep, in 4 steps

Divide missed intakes by booked intakes for each start hour, and move intakes to the hours with the lowest miss rate.

Nate Peereboom
Co-founder, JotPsych

Your new patient misses an 8 AM intake, so your clinician's hour sits empty and the patient's care starts later. You can't tell yet whether 8 AM is the problem.

1. Pull a year of intakes. Export every intake your schedule booked in the last 12 months, with its start time and outcome. Count a cancellation made less than 24 hours ahead as a miss.
2. Work out a miss rate for each start hour. Divide the intakes your patients missed at each hour by the intakes you booked at that hour. Then work out each weekday's rate. Don't use raw counts: your busiest hour can have the most misses because it has the most bookings, even when its miss rate is low.
3. Find the hours your new patients miss most. Look for intake slots in your highest-rate hours. In a 2003 study at an urgent mental health unit, patients who missed a first appointment differed from randomly chosen patients in "time of day of first appointment." The researchers concluded that booking first appointments in the afternoon could reduce no-shows.
4. Move intakes to the hours your new patients keep. Agree on the new times with your clinicians first. "Your physicians have to be ready to support you with that," said Chandani Narula, a practice administrator at Hartford Healthcare Medical Group.

Narula's neuropsychology clinic serves "a huge geriatric population," including patients with Parkinson's disease who have "trouble moving, getting out of their bed in the mornings."

The clinic's appointments started at 8 AM, with "a lot of cancellations and no shows," until the clinic moved the start to 9, 9:30, or 10 AM. "So that really helped us," Narula said.

Narula's neuropsychology clinic also had the most cancellations and no-shows on Mondays. The clinic's neuropsychologist worked three days a week, so the clinic could move appointments off Mondays.