Health care administrators looking for ways to improve service and increase efficiency may want to consider overbooking clinic appointments, according to a study by the University of Colorado at Boulder Leeds School of Business.
Leeds instructor Linda LaGanga and fellow researcher Stephen Lawrence, an associate professor of operations management, found that overbooking could increase patient access and improve clinic productivity, resulting in reduced costs and greater patient satisfaction.
“In an era of rapidly escalating health care costs and calls for improved health care efficiency, these are indeed attractive benefits,” the researchers said in a study that recently received the 2007 Best Paper Award from Decision Sciences, a leading operations management and decision sciences academic journal.
According to the study, overbooking would address patient no shows and enable clinics to see more patients. Potential associated costs: Clinic administrators must be willing to endure increased patient waiting and increased clinic overtime.
LaGanga became interested in the issue after noticing the large number of no shows at the public health care clinic where she works.
“Many clinics overbook, but they don’t do it well,” she said. “Anecdotally, they will admit they do it, but it’s not done systematically. It’s done in the sense of ‘squeezing in’ another patient.”
Lawrence said, “Nobody has studied overbooking in a clinic setting. The benefit of overbooking can far outweigh the costs.”
For their study, LaGanga and Lawrence developed a computer simulation tool that enables health care administrators to weigh benefits such as seeing more patients and making health care workersÂ’ time more efficient against potential costs such as increased patient waiting and staff overtime.
The tool gives administrators an option to decide whether or not their clinics would benefit from overbooking and how they might structure the procedure for greater efficiency. Administrators can then assign a value to the benefit of seeing additional patients against the costs of extra patient waiting and staff overtime. Different administrators might assign different values for their clinics, according to the study.
“If you had a clinic in Hollywood and had only movie stars as patients, you might not want to ever make them wait longer,” Lawrence said. “So the administrator would assign a much higher relative value for increased patient waiting time.”
In contrast, LaGanga’s clinic places a high value on its ability to serve more people. “We want to stop turning people away because of lack of capacity. Seeing one more person in the morning and afternoon could make a great difference,” she said.
The study examined a wide range of clinic sizes and no show rates, which can be as low as 3 percent and as high as 80 percent. Typically, overbooking was most beneficial to clinics that serve a large number of patients, had higher no show rates and had appointments that did not vary greatly in length. However, the study found that many clinics achieve positive results with overbooking even if appointments varied greatly in length.