Decreasing the Date-of-Service Cancellation Rate

Successful applicants to the ASGE Endoscopy Unit Recognition Program submit a summary of a recently conducted quality improvement (QI) project as part of the application process. The quality assurance and performance improvement (QAPI) project in the spotlight this month looked at decreasing the date-of-service (DOS) cancellation rate.

Define

In 2024, we noticed an increase in our DOS cancellation rate from a fairly static 3 or 4 percent to 6 percent. The goal was to decrease the rate back to 4 percent or lower.

Measure

  • Epic measures DOS cancellations and "no show, no call."
  • It also can pull the reasons for DOS cancellations, such as patient illness, ineffective bowel preparation, lack of a ride, etc.
  • Flow sheets were developed on Excel spreadsheets to document calls being made and percentages of patients on the patient portal.

Analyze

Several factors were identified as potential contributors to the increase in DOS cancellations. Factors included:

  • An increase in open access patients being scheduled.
  • Difficulty with communication through the call center.
  • Not having a dedicated phone line for patients to contact scheduling staff.
  • The scheduling staff was not receiving messages in a timely fashion.
  • Patients not on the patient portal did not receive phone calls or follow-up.

Improve

  • The team started making phone calls to patients who were not on the patient portal one week in advance of their procedure.
  • A portal message was created to be sent automatically to patients one week in advance, reminding them about their procedure and to review their instructions and also giving details on where to arrive.

Summary

  • DOS cancellations decreased from 6 percent back to 4 percent with some variability.
  • The findings are communicated to physicians at monthly GI section meetings
  • The process is ongoing.
  • The process is sustainable, but it is too early to assess cost savings at this point.

We hope sharing this project summary will be useful to you and your practice. Learn more about gaining honoree status in the ASGE Endoscopy Unit Recognition Program. EURP honoree units may use the ASGE Quality Star logo in promotion of their units, receive premium educational content via an exclusive e-newsletter The Huddle, and enjoy a range of additional benefits. Questions should be directed to eurp@asge.org.