09 Aug Walk-In Appointments Improved Access To Psychiatric Care

MedicalResearch.com Interview with:

Dr. David Kroll

David S. Kroll, MD
Harvard Medical School
Department of Psychiatry
Brigham and Women’s Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our primary care clinic has the capacity to provide 9 psychiatry evaluations per week, but before we started this project nearly half of the evaluation appointments went unused due to no-shows, and meanwhile the waiting time was two months. We had tried appointment reminders but this had very little impact on the problem—it turns out that forgetting is only a small part of why patients miss their appointments and that instead they have competing obligations—family, housing, legal, etc. Since the traditional model of scheduling and keeping appointments wasn’t working for so many patients, we implemented a referral-based walk-in clinic instead and found that this significantly increased the number of patients who were seen while virtually eliminating our wait list.

MedicalResearch.com: What should readers take away from your report?

Response: No-shows are a problem for patients and clinics alike, but a patient’s risk of missing a psychiatry appointment can be predicted by prior missed medical appointments. This offers an opportunity to intervene before the missed appointment occurs rather than after.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Different clinic settings have different no-show rates and serve different populations with different barriers to care. This model should be studied in other settings, including other psychiatry clinics but also in primary care or other medical specialty clinics where the rate of no-shows is high.

MedicalResearch.com: Is there anything else you would like to add?

Response: Making the change wasn’t as hard as we thought it would be. It made us nervous to refer ten patients to a three-hour slot, but we did not find that this overwhelmed us. The patients showed up, and we made it work.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

The walk-in clinic model improves access to psychiatry in primary care
David S. Kroll, MD Press enter key for correspondence information Press enter key to Email the author,Annie Chakravartti,Kate Gasparrini,Carol Latham,Paul Davidson,Martha Byron-Burke,David F. Gitlin

DOI: http://dx.doi.org/10.1016/j.jpsychores.2016.08.003
Published Online:August 07, 2016

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Last Updated on August 9, 2016 by Marie Benz MD FAAD