Hundreds miss appointments

In May, 704 people did not show up for appointments at Northland District Health Board sites.
"Did not attends" or DNA's are an expensive and constant headache for all district health boards.
In all areas, even in the contentious area of elective surgery, where patients can wait many months for appointments, an average of 23 percent of people don't show up. Each wasted appointment represents staff and services tied up for "no-shows" when they could be used for other patients.
A big new sign at Whangarei Hospital outpatients' department announces that last month, when fewer appointments were made due to the junior doctors' strike, 371 people still stayed home when they should have been at hospital.
Cristina Rood, acting charge nurse of orthopaedic outpatients at Whangarei Hospital, has just finished a six-month project aimed at cutting the number of missed appointments.
She said the main reason people didn't turn up was simple: "They forgot".
Another common reason was patients hadn't received their appointment letter, so simply didn't know to come.
That all meant a big waste of time and money for the DHB, not to mention the health consequences for the patients and flow-on effects for their families and doctors.
Ms Rood said an average of 23 percent of all appointments were missed each month, across all DHB departments including among people who had waited six months for their first specialist appointment for elective surgery.
It'll be about a year before Ms Rood has enough data to measure the effects of new measures aimed at improving attendance through better communication, but the signs look good.
During the pilot project Ms Rood phoned 350 patients ahead of their appointments. The no-show rate among those patients was only six percent.
So now in orthopaedics, and perhaps eventually in other departments too, the DHB rings patients to "negotiate" an appointment time.
"But even after negotiating, people still forget to come."
Other changes that could be rolled out to other areas include simplifying the appointment letter so important details stand out; making a point of telling people of delays and that they should allow several hours for an appointment in case staff are called away to an emergency; and working harder with patients and GPs to check patient contact details.
During the project Ms Rood found about 56 percent of patients' address details were incorrect.
"It's simple but if we get a referral from a GP with wrong information, we send the letter out to the wrong address - we have quite a transient population in Northland."
The biggest problem areas for non-attendance were among 17 to 35-year-olds with fractures, and women of the same age missing gynaecological appointments.
The DHB hoped the community would get behind the project. And judging by the many shocked comments being made about the numbers on the sign at the outpatients entrance, Ms Rood said the public seemed keen to see an improvement too. "It's not about burdening people, it's about communication."