Bringing Value to a Face-to-Face Clinical Appointment
Muskegon Family Care is a federally qualified health center experiencing high rates of patient no-shows and low patient engagement. MFC tried to address this issue on their own by implementing an automatic voice reminder system as well as a human outreach call to remind patients of their upcoming appointments. This did not show a significant improvement in no-show rates. We engaged with MFC to test the hypothesis that high no-show rates were partially due to patients not finding value in their face-to-face clinical appointments. We hypothesized that if we could understand what patients found valuable in their clinical visits, identify the barriers that kept patients from the visits, and improve the experience of the patient/clinician interaction that both clinicians and patients would find the appointments more valuable. This would then reduce the no-show rate.
What was done
We spent two days on site at the Muskegon Family Care clinic. We spent the first day conducting research in the field interacting with patients using co-design activities, observing staff members at work, and interviewing patients and providers about their experiences, expectations, and values during an appointment.
We spent our second day conducting a co-design workshop with clinicians, patients, and staff to gain a holistic understanding of the problem area and identify potential solutions. During this workshop, facilitators guided participants throughout various activities helping them document their experiences, understand different perspectives, and ultimately create prototypes that would improve the value of a clinical appointment for both patients and clinicians. These prototypes have low barriers to implementation, fit with existing workflow, and are easily piloted within the clinic.
MCF had already tried several ways to reduce patient no-show rates on their own. Through our partnership, we were able to introduce new ways of thinking to engage clinicians, patients, and staff members while leveraging their lived experiences and expertise to improve the clinical experience. This new thinking sparked ideas and collaborations within the clinic, creating excitement and support for proposed changes. This group collaborated to create low-cost prototypes that used pre-existing artifacts and process while also leveraging the strengths inherent in existing interactions. We worked with the group to create a strategic implementation plan. This plan guides the clinic through several steps: low-risk pilots, incorporating later iterations based on results of the evaluation, facilitating final implementation within the clinic, and finally measuring success.
Measures of Success
Clinic: Reduce no-show rates, improve clinician retention rates, increase patient satisfaction (HCAHPS)
Patient: improve patient’s perception of value of clinical visits, improve patient satisfaction with clinical visit
Clinician: improve physician burnout
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