PURPOSE

Provides guidelines for establishing criteria for habitual no show and/or late cancellation appointments for Medical, Dental and Optometry Services, the purpose of which is to maximize productivity and to provide quality care in a timely manner. 

A Did Not Keep Appointment (DNKA) is defined as any scheduled appointment that has been missed for the following reasons:

• Patient failed to show up for a scheduled appointment.
• Patient cancels less than 2 hours prior to the appointment.
• Patient arrives 10 minutes or more late and is unable to be seen for a scheduled appointment.

BACKGROUND

Nimiipuu Health (NMPH) experiences a substantial number of DNKA’s which have a significant impact on scheduling. It is the responsibility of the patient to keep their scheduled appointment or notify NMPH when the appointment must be cancelled or rescheduled. All patients are required to provide at least 2 hours advance notice of the cancellation of any appointment for services at NMPH.  A DNKA can:

1. Impact the health and timely clinical care for the DNKA patient.
2. Result in lost time for another patient to have access to timely medical, dental or optometry care.
3. Impact the treatment plan and care for the patients on the schedule for the day.

POLICY

Patients or their legal guardians are expected to keep scheduled appointments. Patients will be informed of the DNKA Policy when making their appointment and will be reminded to call 2 hours prior to the appointment if they need to cancel or reschedule, anything less will be considered a DNKA.  For appointments scheduled for early morning after a weekend or holiday, patients may leave a voicemail with the specific department and this will be acceptable for cancellation of an appointment.

[i] Each department Medical, Dental and Optometry will be treated separately when tracking DNKA’s. Patients will sign an acknowledgement statement that will be kept in their medical record stating that they have received a copy of the NMPH DNKA Policy.

PROCEDURE

1. Utilizing an appointment reminder software, the patient will be contacted via text message, email, or phone call to confirm their visit. If the patient’s preferred method of contact is by “letter”, a letter will be mailed at the minimum of one (1) week prior to the scheduled appointment. Patients will be given a preference for the appointment reminder.  Patients who do not have a phone or do not want to be contacted will be given a written appointment card with a cardholder to place on their refrigerator and a reminder of the appointment.
2. Patients who miss scheduled appointments or need to cancel their appointment on the same day, for unavoidable circumstances, will be determined on a case-by-case basis and reviewed by the Provider before addressing the DNKA Policy. These factors are considered “Urgent” and “Emergent”.  Urgent is when an illness requires attention but is not emergent.  Emergent is an unexpected illness or accident that requires immediate attention.
3. Urgent/Emergent Care is available regardless of a DNKA and will be available to the patient through open access once the patient is triaged to determine the care needed.  If the patient is unable to be contacted and the situation dictates, a referral will be made to the Community Health Department/Public Health Nurse to conduct a home visit.
4. Patients, within a six (6) month time frame, with the first DNKA will have to wait one week to reschedule for an appointment.  The second DNKA the patient again will have to wait one week to reschedule for an appointment.  The third DNKA the patient will have to wait to reschedule an appointment one month out.  The rescheduling wait time will be for the department the patient had a DNKA, i.e. DNKA in Medical affects medical appointments, DNKA in Dental affects dental appointments, etc.  During the probationary wait time the patient has accrued due to DNKAs, the patient will be seen for any Urgent/Emergent visits.
5. All attempts to contact the patient will be documented.
6. Please contact Behavioral Health for their DNKA Policy at 208 843-7244.
7. A patient who has a concern about a DNKA and/or suspension of services, can submit a Patient Comment form to the Patient Advocate.  This process will be considered the appeal process for patients to file when they do not agree with the decision by NMPH.  Patients can refer to the Patient Comment Process Policy.