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"The impact of queue-controlled modified open access scheduling" by Timothy Lesaca MD



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No-shows in child and adolescent psychiatry are a particularly concerning phenomenon that have ramifications beyond productivity and mental health outcomes. One might contend that children have a fundamental right to health care, and the failure to address the no-show phenomenon passively impedes that human right. In this study, a queue-controlled modified open access scheduling model (QCMOAS) was compared to a traditional scheduling model for the incidence of no-shows in a community mental health child psychiatric med check clinic. A six month period of QCMOAS was compared to the preceding six months of traditional scheduling and the six month period exactly one year prior to QCMOAS. Z test was used for statistical significance. For the six month period immediately after the implementation of OCMOAS, a 7.32% decrease in no-show rate was observed, and compared to the six month period exactly 1 year prior to QCMOAS, a decrease of 6.38% was noted. In both cases the result was statistically significant. Preliminary interpretation of this data suggests that the employment of OCMOAS significantly decreased the no-show rate in this community mental health center’s child and adolescent med check clinic. The findings are strengthened by the relatively large number of scheduled appointments reviewed and by the fact that statistical significance appeared to be unrelated to seasonal scheduling patterns. Limitations of this pilot study and recommendations for future investigation are discussed."