Reducing VA No-Shows: Evaluation of Predictive Overbooking Applied to Colonoscopy

NCT01639443 | Completed Results

• 2 other identifiers: IIR 12-0551I01HX000878-01
• Study Type: interventional
• Target: 180
• Locations: 1 country
• Sites: 1

Brief Summary

In this research study, investigators use colonoscopy as a case example to evaluate a predictive overbooking model derived using patient-level predictors of absenteeism. The no-show overbooking intervention employs a logistic regression model that uses patient data to predict the odds of no-showing with 80% accuracy. These projected no-show appointments will be overbooked by clerks for patients who agree to join a "fast track" short-call line. By rapidly processing endoscopy patients and moving them out of traditional slots, investigators predict more scheduling slots would become available for patients awaiting colonoscopy.

Conditions

Colon Cancer

Keywords

quality improvement; Organization and Administration; Costs and cost analysis; Patient satisfaction; Health plan implementation

Outcome Measures

Primary Outcomes (1)

• Percentage of GI Clinic Capacity Filled

  Investigators' primary objective will be to evaluate the impact of no-show predictive overbooking on percentage of the GI endoscopy clinic that are filled on a given day. Days where at least one Fast-tracked patient attended an appointment were compared to days where only Control patients attended appointments. Percentage of GI Clinic Capacity is calculated as the number of appointments completed divided by number of appointment spots available on a given day. This percentage was compared between Fast-tracked days and Control days, using data from 1672 patients.

  After 12 months of running study in clinic

Secondary Outcomes (5)

• Scheduling-to-procedure Lag Time

  After 12 months of running study in clinic

• Daily Service Denials ("Bumps")

  After 12 months of running study in clinic

• Advanced Adenoma Detection/Cecal Intubation Rates

  After 20 months of running study in clinic

• Length of Workday

  After 12 months of running study in clinic

• Cost Comparisons

  After 12 months of running study in clinic

Study Arms (2)

Fast-tracked

EXPERIMENTAL

'Predictive no-show overbooking' intervention. Patients who volunteer to enroll in "fast-track" line, which gives them an opportunity to overbook their appointment for endoscopy earlier in a predictive no-show slots.

Other: Predictive no-show overbooking

Control

NO INTERVENTION

Patients who are scheduled routinely

Interventions

Predictive no-show overbooking OTHER

During intervention period, every Veteran scheduled for an endoscopy will be offered "fast-track" offer, which gives them a chance to get their endoscopy procedure done earlier than usual scheduling by overbooking their appointment in a predictive no-show slot.

Fast-tracked

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients who are scheduled for upper endoscopy and agree to the terms of "fast track" offer.

You may not qualify if:

• If a patient expresses concern about service denial, confusion about the bargain, or refuses to participate, the investigators will schedule these patients routinely.

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073, United States

Location

Related Publications (3)

• Reid MW, Cohen S, Wang H, Kaung A, Patel A, Tashjian V, Williams DL Jr, Martinez B, Spiegel BM. Preventing patient absenteeism: validation of a predictive overbooking model. Am J Manag Care. 2015 Dec;21(12):902-10.

  PMID: 26671702 RESULT

• Reid MW, May FP, Martinez B, Cohen S, Wang H, Williams DL Jr, Spiegel BM. Preventing Endoscopy Clinic No-Shows: Prospective Validation of a Predictive Overbooking Model. Am J Gastroenterol. 2016 Sep;111(9):1267-73. doi: 10.1038/ajg.2016.269. Epub 2016 Jul 5.

  PMID: 27377518 RESULT

• May FP, Reid MW, Cohen S, Dailey F, Spiegel BM. Predictive overbooking and active recruitment increases uptake of endoscopy appointments among African American patients. Gastrointest Endosc. 2017 Apr;85(4):700-705. doi: 10.1016/j.gie.2016.09.001. Epub 2016 Sep 10.

  PMID: 27623103 RESULT

MeSH Terms

Conditions

Colonic Neoplasms; Patient Satisfaction

Condition Hierarchy (Ancestors)

Colorectal Neoplasms; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Treatment Adherence and Compliance; Health Behavior; Behavior

Limitations and Caveats

This study was impeded by our ability to schedule Veterans into Fast-Tracked appointments. Although the method is very promising, integration of predictive scheduling is vital for this program to benefit Veterans on a large scale.

Results Point of Contact

• Title: Jennifer Talley Soares
• Organization: West Los Angeles VA / Cedars-Sinai Medical Center

jennifer.soares@va.gov

(310) 478-3711

Study Officials

• Paul G. Shekelle, MD PhD MPH

  VA Greater Los Angeles Healthcare System, West Los Angeles, CA

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 9, 2012
• First Posted: July 12, 2012
• Study Start: July 8, 2013
• Primary Completion: July 6, 2015
• Study Completion: June 30, 2016
• Last Updated: April 12, 2018
• Results First Posted: October 31, 2016

Record last verified: 2018-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)