CHM, CHwapi: how do our hospitals fight against appointments not kept by patients?

CHM, CHwapi: how do our hospitals fight against appointments not kept by patients?
CHM, CHwapi: how do our hospitals fight against appointments not kept by patients?

In HoReCa jargon, the practice is called “no show”. It refers to reservations taken in a restaurant without being subsequently honored. Since the covid years, they have sadly become a recurring phenomenon and are giving restaurateurs gray hair.

Surprise or not surprise: HoReCa is not the only sector facing no shows. The hospital environment is also affected by a phenomenon which represents at least 2% of consultations at CHMouscron and around 3.5% of consultations at CHwapi. A bad practice which cannot be dissociated from an issue raised a week ago in our newspaper: the delays in obtaining an appointment with certain specialists.

Our editorial staff carried out a “life-size” test by trying to find a slot for a knee ultrasound. Verdict? A meeting at the end of May in Ath, in June in Tournai, in July in Mouscron. On the Flemish side, we obtained three meetings respectively on May 2 in Ronse, May 6 in Grammont and May 7 in Kortrijk. “The number of no shows is actually a little more significant in specialties where the time to obtain an appointment is longer. But it is not really possible to deduce a single reason from this”, explains Sophie Schraen, spokesperson for the CHM.

In Tournai, the number of “defections” doubled between 2022 and 2023, going from 1.6 to 3.5%. The first explanation must also be sought in terms of deadlines. “They are higher. As a result, our teams are faced with a phenomenon that we can call medical shopping.”, explains Nathalie Watteau, the coordinator of the CHwapi medical secretariat. “Medical shopping is a practice which consists of calling elsewhere to find an appointment closer in time… without canceling the previous one.

+ READ ALSO > TESTIMONY: What is the state of health of the hospital environment? “We are asked to do much more with much less”

At CHM and CHwapi, however, it is not the fault of putting in place safeguards to limit this bad habit! “Our patients receive a reminder message 72 to 48 hours before the appointment. In this SMS, we find the number to contact in case of unavailability to cancel or postpone the appointment. Some services go further and telephone patients to ask them if they plan to travel. These two strategies make it possible to reduce the number of no shows and above all to offer other patients the possibility of accessing an appointment more quickly. We also sometimes create lists of callable patients who can easily become available to fill a last-minute canceled appointment.”, continues Sophie Schraen.

The same goes for the hospital in the city of Cinq Clochers, where patients receive an SMS 48 hours before the appointment. “In reality, they receive two messages. The first when making the appointment to confirm it and the second, two days before the date”, explains Nathalie Watteau. The content of the SMS? “In addition to the reminder, we reference a telephone number and an email address specially dedicated to cancellations ([email protected]). A cancellation, even late, can free up certain slots by convening patients who need an urgent appointment or a consultation that should not drag on.

Both hospitals are also showing less leniency, if necessary. “We charge an amount of 15 euros as a deterrent for appointments not honored or excused. Information disseminated within the institution”, confides Sophie Schraen for Mouscron. In Tournai, the penalty is exactly the same (15 euros) but the process differs. “This is at the discretion of the specialist. He has the possibility of claiming this amount from the patient who does not show up, but not the obligation. Some are accustomed to no shows, they are relatively less spared than patients who are identified for the first time.

Often, no show is synonymous with a vicious circle. Example: the patient makes an appointment for a consultation where the delay is quite long, in cardiology or neurology. He does not cancel, even two days before the deadline. In fact, the most urgent slots remain blocked until the precise minute of the appointment, “often in disciplines where obtaining one quickly is not easy”, adds Nathalie Watteau.

The repercussions on the nursing staff? They are real. “He can sometimes feel frustrated, but he tries as much as possible to educate patients. A canceled appointment means a free consultation”, admits Sophie Schraen. The feeling is the same in Tournai. Nathalie Watteau adds “frustration of administrative staff, who have to deal with the discontent and aggressiveness of certain patients on the telephone, but who are powerless since they have no solution to reduce the time of a medical appointment.” The two hospitals also raise the question of costs. “Certain scheduled activities generate medication and material resources. If the patient is not present, this can cause significant losses. I take the example of scintigraphy, where the product used for the examination is ordered according to appointments”, indicates the CHM spokesperson. “Finally, staff may also feel worried when some patients do not show up and it is unusual for them to do so.”


An awareness campaign on aggression and no shows

Nathalie Watteau rightly says it: staff are sometimes confronted with the aggressiveness of certain patients who struggle to understand the deadlines for obtaining an appointment. “An awareness campaign will be carried out soon. It aims to remind people of the importance of showing up or canceling before the big day. It also aims to explain that, although we have duties and responsibilities towards patients. The opposite is also true…

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