"Better Late Than Never": Methods of Dealing With No-Shows In Nuclear Medicine During The COVID-19 Pandemic

Objectives: In scheduling, “no-shows” are patients who make appointments, but neither keep nor cancel them. No-shows in the nuclear medicine department lead to waste of valuable resources, revenue and staffing; all which cost time and money, regardless if patients show up or not. During the COVID-19 pandemic, hospitals have demonstrated a profound lack of appointment adherence, leading to even more waste of resources. Here, we discuss methods of dealing with no-show patients to reduce anxieties around the virus and to promote adherence to appointments.

Methods: Fear is a natural biological defense mechanism used to deal with threats acutely. When chronic, this can become disproportionate and unbeneficial to the health of the organism. During the COVID-19 pandemic, fear has been shown to perpetuate anxiety and stress in healthy patients, while intensifying symptoms in less healthy patients. This fear has also decreased appointment adherence, which negatively impacts the nuclear medicine department. Thus, it becomes important to understand our patients and their fears, beliefs, or reasons for not keeping their appointments, if we seek to reduce the no-show rate. One particular method we may use is the human-centered design method, which consists of patient interviews and qualitative research to better understand human behavior in order to develop innovative ways to combat problems we may face. By collecting information on why patients do not attend their appointments, we may be able to understand, and thus formulate creative ways to improve compliance tailored to our communities. Another useful method can be retrospective and qualitative data collection of patients who “no-show” in the electronic health record. By compiling the patients who no-show and identifying psychosocial factors, we may be better able to identify obstacles to care and develop ways to combat them in ways that are tailored to the patient. Overall, a humanistic approach to our patients might prove beneficial in the long run if our aim is to reduce no-shows going forward.

Results: Common fears of patients during the COVID-19 pandemic have been due to misinformation and lack of education about the virus, skewed information from the media, the fear of death from the virus, and hospitals being thought of as infectious reservoirs for the virus. Through patient interviews, data collection, and examining the electronic health record of our patients, we can design flyers, informational pamphlets, advertisements or posters which seek to target these populations and distribute information to them in order to reduce their anxieties. In addition, by identifying obstacles to care, we can develop methods that remove or lessen these burdens so that our patients have improved access to the care they need.

Conclusions: Through use of humanistic methods and data collection to understand our patients fears, we are better able to appreciate their motives, particularly their reasons for appointment non-adherence. This way, we can help our patients quell those fears, and promote the importance of keeping appointments so that we maximize both their care and the use of resources in the nuclear medicine department.