...Access Reduction of missed appointments at an urban primary care clinic: a randomised controlled study Noelle Junod Perron1*, Melissa Dominicé Dao1, Michel P Kossovsky1, Valerie Miserez1, Carmen Chuard1, Alexandra Calmy2, Jean-Michel Gaspoz1 Abstract Background: Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. Methods: We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile) reminder; 2. If no phone response: a Short Message Service (SMS) reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. Results: 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122) in the...
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...Required Textbooks and Equipment Instrument Commercial Manual, Jeppesen (current edition). ICM Airman’s Information Manual, FAA (current edition). AIM Federal Aviation Regulations, FAA (current edition). FAR Airport Facilities Directory, NOAA (current edition). AFD FAA Instrument Pilot Exam Questions/Answers (Gleim). FAA IFR ENROUTE LOW ALTITUDE charts – U.S. L-23/24 US Terminal Procedures (Approach plate) – SE-3 Optional- Jeppesen Chart Subscription, (current Florida coverage). Aviation Weather Services, NOAA, AC 00-45C (current edition). AWS Course Description This course develops aeronautical knowledge required for addition of an Instrument Airplane rating to a Private Pilot certificate. Topics include instrument flying regulations, safety, operations, navigation systems, chart use, weather, flight planning, decision-making, and crew resource management. Prerequisites AS 121. Course Goals This course provides the aeronautical knowledge to continue the development of a professional pilot through practical application of basic aerodynamics, aircraft performance, regulations, and flight planning in a single-pilot, IFR environment. This course also continues to build the understanding of those essential elements of crew resource management, such as crew communication, crew coordination, and teamwork required by the aviation industry. Performance Objectives During this course the student will, to the...
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...AVIATION SAFETY PROGRAM EASTERN SKY AIRLINES DIEGO LUIS PALACIN ENDERS INDEX 1. SECTION ONE: SAFETY POLICY 2. SECTION TWO: SAFETY AND HEALTH RESPONSIBILITIES 3. SECTION THREE: EMPLOYEE PARTICIPATION 4. SECTION FOUR: SAFETY RULES AND REGULATIONS 5. SECTION FIVE: DISCILINARY POLICY 6. SECTION SIX: HAZARD RECOGNITION, PREVENTION AND CONTROL 7. SECTION SEVEN: ACCIDENT/INCIDENT REPORTING 8. SECTION EIGHT: EMERGENCY PLANING AND RESPONSE 9. SECTION NINE: SAFETY AND HEALTH TRAINING AND EDUCATION 10. SECTION TEN: SAFETY AND HEATH ASSISTANCE RESOURCES 11. SECTION ELEVEN: CONTACT INFORMATION SECTION ONE SAFETY POLICY Safety is a team effort – Let us all work together to keep this a safe and healthy workplace Eastern Sky Airlines places high value on the safety of its employees and passengers. Eastern Sky Airlines is committed to providing a safe workplace for all employees and has developed this Aviation Safety Program for injury and accident prevention to involve management, supervisors, and employees in identifying and eliminating or reducing hazards that may develop during ground or air operations. Eastern Sky Airlines Safety Program objective is to create a safety culture in which we stress to all employees that safety is as important as any other business function. Only thought the joint commitment on the part of management and employees can workplace accidents and injuries be reduced or eliminated. Employees should be encouraged to not only work safely...
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...Hendrick Motorsports Aircraft Accident The National Transportation Safety Board (NTSB) report examined the events of flight N501RH, operated by Hendrick Motorsports Incorporated on October 24, 2004 from Concorde, NC to Martinsville, VA, and its unsuccessful approach to Martinsville Ridge Airport. Several factors were determined to be as expected for a normal flight path while others were askew. The resulting deaths of the passengers onboard can be attributed to human errors and management shortfalls as there were no mechanical anomalies. Background Flight N501RH was a Beech King Air 200 manufactured in 1981 and had a total time on plane of 8,140 hours. All maintenance inspections were up to date. The aircraft left Concorde, NC on October 24, 2004 and had a flight plan to head to Martinsville Airport in Virginia. The aircraft was equipped with a global positioning system (GPS) though the database was not current making it uncertified in instrument flight rules (IFR) flight plans. Owned and operated by Hendrick Motorsports, the passenger list consisted of two crew members, six members belonging to Hendrick Motorsports and two additional passengers. Sequence of Events The aircraft departed from Concorde at 1156 en route to Martinsville. The flight was routine and all data and communications during the flight were normal. The pilot maintained all assigned heading and altitudes. No warning signs were identified until the aircraft approached the localizer...
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...increased financial burdens and inaccurate or missed diagnoses of patients (Goldman et al., 1982). Previous studies have shown that various patient factors can predict future no-show behavior. For example, the type of appointment scheduled for a patient can predict patient absenteeism (Zeber, Pearson, & Smith, 2009). Zeber et al. found that colonoscopy appointments are the most commonly missed appointments (Zeber et al., 2009). Furthermore, previous missed appointments is one of the most significant predictors of no-show appointments (Dove & Schneider, 1981). Studies have also shown that patients’ various psychosocial diagnoses are indicators of missed appointments (Goldman et al., 1982). Patients diagnosed with at least one psychological diagnosis, including mood disorders, such as depression and bipolar disease, anxiety disorders, such as panic attacks and posttraumatic stress disorder, and thought disorders, such as schizophrenia and personality disorders, were more likely to miss appointments compared to patients without psychological diagnoses (Savageau et al., 2004). Finally, Perron et al. showed that patients with substance abuse disorders are more likely to miss appointments (Perron et al., 2010). In order to reduce no-show rates in a hospital gastrointestinal (GI) clinic this project analyzed potential indicators of missed appointments. Based on a conceptual model grouping various barriers that lead to missed appointments (Figure 1, Appendix A), patient level factors...
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...products and services by appointments is constantly running late and missing appointments. The company schedules appointments to resolve the customers issues, but the main issue is that the company does not make it to the appointment on time or never shows up at all. The company should take drastic measures to keep the commitment of going to the customers home in order to provide excellent customer service. It is imperative that this company finds a solution to this issue because there are a large amount of customers being inconvenienced every day due to the late and missed appointments. In the scheduling process of the appointments the company tries to make each customer happy by giving them the date they are requesting. With this being the case the days ends up getting overbooked. The company allows an overbooking percentage of up to 103-105% for the load. While the company is giving the customer the date they want, essentially they are pushing other customers out of the load. There are managers assigned to each state and those states are broken down into different regions i.e. north, south, east, west. It is the duty of the load manager to make sure that each job gets assigned to a technician so that every customer is serviced in a timely manner. The company expects that there will be unforeseen events that may cause the technicians to run behind i.e. traffic, car issues, and wrong addresses on the account. The company provides a 4 hour appointment window, for example,...
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...1. INTRODUCTION 1.1 Industry Overview The health care industry, or medical industry, is an aggregation of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. Health economy is another term used to describe this field. It includes the generation and commercialization of goods and services lending themselves to maintaining and re-establishing health. The modern health care industry is divided into many sectors and depends on interdisciplinary teams of trained professionals and paraprofessionals to meet health needs of individuals and populations. The health care industry is one of the world's largest and fastest-growing industries. Consuming over 10 percent of gross domestic product (GDP) of most developed nations, health care can form an enormous part of a country's economy. For purpose of finance and management, the health care industry is typically divided into several areas. As a basic framework for defining the sector, the United Nations International Standard Industrial Classification (ISIC) categorizes the health care industry as generally consisting of: 1. Hospital activities 2. Medical and dental practice activities 3. "Other human health activities". This third class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, or other allied...
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...Days and hours of every appointment and treatment (Fremgen, 2012). • History of the presenting illness (Fremgen, 2012). • Review of symptoms, and why the patient came in to the office (Fremgen, 2012). • Main Complaints (Fremgen, 2012). • Results of the exam performed by the doctor (Fremgen, 2012). • Doctor’s assessment, diagnosis, and what he/she recommends as far as treating the illness (Fremgen, 2012). • Progression documentation of former appointments and therapeutics (Fremgen, 2012). • Medical problems of kindred (Fremgen, 2012). • Individual medical problems (Fremgen, 2012). • History of medicines as well as notes regarding all orders to refill meds (Fremgen, 2012). • Treatments (Fremgen, 2012). • X-ray reports (Fremgen, 2012). • Lab reports (Fremgen, 2012) • Reference Statements (Fremgen, 2012). • Identification of disease or illness (Fremgen, 2012). • More communication regarding patients include: when it is needed, documents regarding compliance, patient’s permission to give out information, and a copy of a living will if the patient has one (Fremgen, 2012). • Documents regarding all prescription medication and all authorizations to refill prescriptions (Fremgen, 2012). • Documents regarding the copying of medical records, and documents regarding whom these documents were sent to (Fremgen, 2012). • Documents regarding patients not showing up for appointments, and what actions were taken in regards to the missed appointment such as calling the...
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...Fairview Medical Associates Financial Policy In an attempt to keep your medical cost for services to a minimum, we have adopted the following policy regarding payments and billing. If you do not have insurance coverage, payment will be due in full amount on the day the service is giving. Copayments and Deductibles You are expected to pay your copayments and deductibles at the time of service. All payments are required at the time of service unless other arrangements have been made in advance. Fairview Medical Associates accepts cash, personal checks (in-state only), VISA, and MasterCard. There is a service charge of $25.oo for any returned check (Smith, 2009). Past Due Balances ALL ACCOUNTS MUST BE PAID IN FULL WITHIN NINETY (90) DAYS from the date of service or payment arrangements need to be arranged before medical service can be provided (Valerius, 2008). The unpaid balance is your responsibility and must be paid. We will submit your insurance claim to your Primary Insurance Companies as a courtesy to you (Valerius, 2008). After the 90 days, you outstanding balance is due regardless of your insurance claim status. If the process of filing the claim is delayed we request that you assist us in concluding the process (Valerius, 2008). Arrangements need to be made before the 90 days from the date of service .Consecutive payments are to be made in order to continue to have medical services provided by Fairview Medical Associates. Noncovered Services If you are unsure...
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...not extracting his infected tooth on his examination day. Dr. Furlow received the complaint on March 1. He took the complaint home, locked it away in his vault and later contacted us. He had 20 days to reply. Our office gave Dr. Furlow an appointment for March 19. His home was robbed on March 18 and the complaint stolen along with other items. Fearing for his family, Dr. Furlow went to stay with his in-laws from March 18 to March 22, forgetting about his appointment with us on March 19. He contacted us on March 22, when we gave him an appointment for March 23. The court clerk told us on the afternoon of March 23 that a default judgment had been entered. We immediately filed a motion to set aside the default judgment. Question(s) Presented: 1. Could Dr. Furlow have extracted John Brown’s tooth on the day that he examined him? 2. Was Dr. Furlow negligent in only recommending instead of insisting that John Brown return with the infected tooth? 3. Should Dr. Furlow have advised John Brown of the risk of not returning with the infected tooth? 4. Was Dr Furlow negligent when upon realizing that he missed his March 19 appointment, come directly to our office on March 22 instead of calling and making a further appointment? 5. Were we negligent in not insisting that Dr. Furlow come to the office on March 22 instead of...
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...TerriResse Jones 208 Southwind Dr. #14, Athens, AL 35611 #22026522, Legal Writing 1, #008033 Law Offices of Eliza Smith & Associates 5678 Barrister Row Clark, Pennsylvania 18112 (771) 333-4444 Fax (771) 333-4445 April 21, 2014 Jane P. Smith 123 Rock Road Clark, PA 18118 Re: File No. Smith-3-04 Dear Ms. Smith, This letter is to inform you, that your tax appeal hearing has been scheduled for March 6, 2005, at 10:30 a.m. The hearing will be held at the County Office building located at 211 Race Road. The court room is located on the 5th floor. Ms. Smith, would like for you to meet her in the lobby ten minutes before the hearing begins. She asked, that you bring the pictures of all the comparable houses in your area, as discussed per your earlier meeting with her. If you have any questions, or need any assistance, please contact me at (217) 695-3568. Very truly yours, TerriResse Jones Cc: Eliza Smith THIS DEED Made the 21st day of April, in the year Twenty Thousand Fifteen (2015) Between, JANE P. SMITH, of the Township of Dalton, Lackawanna County, Pennsylvania, hereinafter referred to as the Grantor A N D ADAM JONES and SALLY JONES, husband and wife, of the Township of Dalton, Lackawanna County, Pennsylvania, hereinafter referred to as the Grantee. WITNESSETH, that in consideration of the sum of One Hundred and Fifty Thousand ($150,000.00) Dollars, in hand paid,...
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...that is where you will be. What a lot of Soldiers do not understand that includes appointments made by them or someone else. We have appointment times, SP times, formation times and many other start times that dictate we will be there. If a Convoy has an SP time of fifteen hundred hours and the Soldiers decide to show up late because they did not feel like getting ready on time people could die. If they rolled out on time, they may have avoided the ambush or avoided the Vbid that hit them in the bottleneck. It sounds extreme but time management plays a critical role in the Army. When you make an appointment that spot has been reserved for you. That means if you have been given the last slot someone else is going to have to wait for another one to open up. This could be one day or one month. And because you missed it someone else is still going to have to wait when they could have had that spot and been there. If you are going to miss the appointment or cannot make it due to mission they do allow us to cancel the appointment with in twenty four hours. The Army allows us to make appointments for whatever we need. Be it for a medical appointment, house goods, CIF, Smoking Sensation or whatever we need these recourses are available to us. But when Soldiers start missing appointments theses systems start to become inefficient. What a lot of Soldiers do not realize is that when they miss an appointment it does not just affect them; it affects the entire chain of command from the Squad...
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...bottleneck of the process. The MRI clinic is experiencing problems; the relationship between BCMC and Quinte MRI is in trouble because promised expectations of 2 scans per hour is not met, performance is reduced , productivity is declining and they are at risk of losing their competitive edge. Balancing the process flow will make the operation more effective and manageable. With the process the way it is there are a lot of variability and uncertainties that I will have to contend with. By better managing the scheduling process I will definitely reduce wait times and increase productivity to meet set expectations of two per hour, which gives an output rate of 16 per an 8 hour shift. KEY ASSUMPTIONS • Backlog/ wait time for an appointment is always 14 days per patient. • Receptionist has idle time during an 8 hour shift • The MRI clinic is in operation for 250 days per year. • Scheduled time for any given procedure is from...
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...this kind of policy is communication. Make sure that the patient understands the medical physician’s policy. In the health care field effective communication is the vital role in the way a healthcare provider provides patient care. It also has a direct role in the way the patient receives care and the way the physician complies with the standards and regulations set forth by HIPAA and the state. Emergency. In the event that there is a medical emergency, the patient may call the office after hours and receive assistance from the answering service. If necessary a physician can be reached to return the patients phone call immediately. Missed Appointments . In the event that an appointment cannot be kept, this medical office requests at least a 24 hour notice of cancellation. These fees are not covered by the insurance company. If the appointment is cancelled without proper notice a fee of $25 may apply. If the appoint needs to be cancelled please call during business hours. Please do not call after hours or leave a message because these messages may not be received until the next business day. Co-payments. It is the policy of this office to collect co-payments, deductibles and past due balances before additional services can be rendered. This medical facility will file a claim to the insurance company on your behalf but ultimately it is the responsibility of the patient to make sure the services rendered...
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...sending and receiving is more visual between people. These Messages can be communicated with gestures and even a touch, the more of a body language even a posture. The facial expression and eye contact are used to. The scenario of Maria the parole officer and Alex the criminal. Maria the parole officer has just got ahold of Alex to come back into her office because he missed last month’s appointment. As a parole officer Maria has the right to see what is going on with Alex and why he never showed to this last appointment. When Alex came into the officer Maria was talking to Alex and asking him question Alex was not making eye contact with Maria while he was answering her question he was avoiding eye contact. Marias has assumed that he is hiding something from her because he was advoiding eye contact with the parole officer. Alex did miss one of his appointments but would make contact to tell her why he misses his appointment so she knows something was not right. Maria has a lot of power to get Alex in a lot of trouble. Alex seems to be nervous and doesn’t want to talk to Maria about why he wasn’t there for his appointment. In most circumstances with avoiding eye contact might also show a sign of shyness or maybe even embarrassed but in this case it show that he had done something he shouldn’t have and doesn’t want to tell Maria about it. He is advoiding it in every possible way instead of just telling her what happen or why he is making her know that something is up. If Alex would...
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