Shedding light on the mystery of dn as 2
Download as pptx, pdf0 likes303 views
This document discusses DNA (did not attend) rates for GP appointments and how implementing a same-day appointment system can significantly reduce DNAs. It finds that the DNA rate rises the longer the wait time between booking an appointment and the actual appointment. A case study of a practice in Salford showed reducing the average wait from 3 days to under 1 day, with 90% of patients seen the same day, led to over a 50% reduction in DNAs. The document argues that DNAs are more a system problem related to wait times rather than a patient behavior problem, and changing to a same-day appointment model is an effective solution.
Shedding light on the mystery of dn as 2
- 1. Shedding light on the mystery of DNAs in general practice Harry Longman April 2013
- 2. Another 10 minutes wasted. Why does it matter? That so-and-so will go round the loop and see me again They were turning patients away on reception, who did need to see me Just another 贈200 million problem for the NHS
- 3. Spot the relationship between GP DNAs and how many days the patient waits between the booking and the appointment. Same day DNA The rate rate is 1.4%. rises steadily Within a single day to between it jumps to 3% 4 and 5%
- 4. For other clinicians in practices, ie not the GPs, the same relationship applies but DNA rates are higher overall. Same day DNA The rate rate is 1.3%. rises steadily Within a single day to between it jumps over 3% 6 and 7%
- 5. What hasnt worked (much) in the effort to reduce DNAs? Reports of 20% reduction with text messaging? If this worked they would stop having to do it wouldnt they?
- 6. The obvious solution: if all appointments were offered on the same day, DNAs would drop. As many as possible just here problem solved
- 7. Average days wait at this Salford practice dropped from three to under one, 90% seen the same day. A few patients choose to wait a day or two. Intervention, new system launched in week 41
- 8. Reduction in DNAs is not the aim, but merely a by product of a fundamental change to the access model. Admin question Come and see GP 30% 10% 70% Reception GP phones patient takes call 60% Problem 20% 10% solved Come and see nurse PA Navigator measures the flows, which vary by GP & practice.
- 9. As predicted, DNAs for GP appointments have dropped over 50%. Similar outcomes are seen repeatably with other practices.
- 10. Now, are DNAs a people problem or a system problem? How many years are we going to try changing behaviour? Or just change the practice system in four weeks.
- 11. Note on analysis method Data was collected from 39 practices Periods are from January 2011 to March 2013. Total count of appointments analysed: n = 837,208 Method: Select face to face appointments and count by number of days between booking and appointment. DNA rate = (count of DNAs)/(count of DNAs plus finished) Summary Role Status Count GP Did Not Attend 11015 Finished 438841 Other Did Not Attend 18094 Finished 369258 Harry Longman www.patient-access.org.uk