The Challenge
The Neuro Physiotherapy outpatient service was experiencing a no-show rate of 18 percent, more than double international benchmarks. Appointment waits were longer than clinical guidelines recommended, engagement with the service was low, and many patients arrived without a clear understanding of what to expect or why they had been referred.
The financial impact was significant, with the department losing approximately $2,750 CAD per physiotherapist each month to unused appointment slots.
The Approach
A detailed review of processes, patient experience data, and workflow inefficiencies revealed the root causes. Value stream mapping, stakeholder consultation, and multiple PDSA improvement cycles were used to redesign access and patient engagement:
- A new triage and scheduling system was introduced to ensure patients were prioritized appropriately and booked in a sequence matching their clinical need
- Reminder calls were implemented 24 to 48 hours before appointments to reduce unintentional non-attendance
- Porter assistance improved the reliability of patient movement through the facility
- An information-sharing mechanism was introduced at the point of referral so patients arrived better prepared and more committed to their appointments
The Outcome
The no-show rate fell from 18 percent to 9 percent. Waiting time breaches dropped from 80 percent to 20 percent. Clinical utilization reached 80 percent.
The service realized approximately $210,000 CAD in annual efficiency gains by recovering unused appointment capacity and improving overall service flow.