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Well I'm trying to figure this out and document this well. If a new consult/patient doesn't show up, how are you guys documenting this in AC?

I clicked the DNKA (Did Not Keep Appointment) and the patient simply disappeared off the schedule. Now, I can't find any documentation that the patient was ever scheduled and further more did not keep the appointment.

I simple wanted the DNKA button to keep the appointment on the list but mark it so I know the patient did not show up (either by changing colors or whatever).

I didn't think much of this at first but... A patient didn't show up, we marked her as DNKA, and then she calls and says she was never told she had an appointment and wanted to know which day, etc. We couldn't tell her. Frustrating.

So I'm just leaving them on the schedule right now without any documentation of not keeping the appt except that there is no note for the day (not a good way of doing it though).

How are you guys doing this? Or am I missing a big red button labeled "EASY"?

I was not aware this was happening either. One way around this is to have your staff select the "notify provider" option when they are at the DNKA screen. That then sends a message to a provider's inbox and that message can then be saved to the chart. Once saved there, it will show up in their past encounters and will give the date and time of the appointment which was missed. But I agree, the DNKA should automatically save to the chart without having to send it to a provider.

Leslie

I can think of another couple options.

1) Make a phone message, have staff indicate the subject heading as "no show" and write the date/time they no showed.

2) Go to the demographics tab in their chart and mark under the Yellow Popup Notifications window, the date/time of their no show.

In our FP clinic, we regularly monitor when a patient no shows and/or cancels appts. The only way we've found to track that is the staff notify themselves and save it to the chart. Some doctors want to know when a patient no show'd to make sure we get them the follow up treatment they need. I haven't found an alterative way to get that information tracked and saved. What would be nice, (dream world here) is if the schedule was kept. Reschedules shown in the visit history, cancellations, and no shows without requiring it to be saved to the chart as a message.

One way to trakc no shows is to do an addendum.
The addendum pop up have a DNKA option; it will not remove the missed appointment in the schedule.

I've deceided to use Leslie's option at this time. It is critical to risk management to document no shows in the chart as a mater of non compliance and a scheduling issue.

If you use the notify provider option it also gives the doc the chance to call, write a letter or generate e mail to someone. This is good for the liability aware docs to make a decision about how to handle.

JTU, when you click the DKKA a box should appear giving you the choice to "Notify Provider" or not to notify. Choose notify (or have staff choose nofify), and a message and a message will be sent to you. You can then save the message to the chart.

but the message that gets sent to the provider to sign off on does NOT contain what the appointment was about, when it was originally made, and who made it.

Carolie,

I agree with you that we need to be able to have more of a comments section on the schedule. We seem to be having a lot of mistakes being made in scheduling but I cannot track who is making them so that I can speak with them and correct it. When an appointment is made the user who made the appointment is indeed noted as is the date. However, we confirm appointments 1-2 days before and then use the comment section to note they were confirmed or left a message, etc. I charge for No Shows based on whether or not they were confirmed. Once whoever confirms notes this in the comment section, the name of the person who originally made the appointment is exchanged for the person who confirmed. Then a patient comes in for a
15 minute "follow up" when in fact it should have been a 40 minute "complete" and my whole day has just been screwed. I need to know who made the original error in scheduling.

Leslie

True it does not provide that information and what you described is an issue we have had to deal with in the past. Unsuccessfully.

When we went to AppointmentQuest, we had fewer errors on the part of staff. But we confirmed that alot of the errors were due to patients themselves. For instance, a patient scheduleing a visit for cough/cold symptoms, but when they arrived they told the assistant they were in for "a checkup." But now we had where they had scheduled the appointment themselves online and listed cold symptoms. or sometimes they just dont bother discerning what type of appointment they should be scheduling. Guess we have too many types (5) http://www.appointmentquest.com/provider/2100062625

You can't fix some issues, namely patients saying one thing to us and one thing to the MA's, and then yet another thing to the doctor. I truly believe that patients really have no concept of their impact on not only the doctors day, but the days of every other person who is scheduled to be seen. I have found a sort of work-around at least for documenting what the appointment was for. When you cancel or no show an appointment - take a look at the comments and what the appt was scheduled for. When the pop up for notifying the provider is done, you can type in that window and add information such as what the appt was for and any other comments that may be relevant to it such as their reason for canceling. Then send it off to the provider. At this point, we send the message to ourselves and save it to the chart which shows up as information to be reviewed when the doctor looks at the chart again, or the nurses work on prescription refills. Its not ideal, and still doesn't solve the problem of tracking down the source of mistakes - but it helps with part of it. I'm waiting to see what the PM program brings as far as changes to the system if any.