Staff spends too much time making appointments that are not kept. No-shows for assessment appointments prevent other clients from using that time slot.
Establish walk-in hours so that clients are able to see a counselor for an assessment without an appointment.
The Center for Drug Free Living in Orlando, Florida reduced waiting times for treatment by implementing walk-in appointments. At first they held walk-in hours from 1-3 p.m. Monday through Thursday and gave clients the choice of scheduling an appointment or using the walk-in hours. Later, they shifted the walk-in hours to 8:30 a.m. Monday through Thursday and eliminated scheduled assessments altogether. They now serve 4-6 clients per day. This change eliminated their waiting list for outpatient treatment and is now an established program policy. Their automated voice messaging system now explains the walk-in procedure in detail.
Central New York Services in Syracuse, New York eliminated both waiting times (from 36 days) and no-shows for assessments (from 50 percent) by offering walk-in appointments on a first-come, first-served basis. Billable assessments increased from 38 to 71 in the first month. They informed their referral sources about this change, contacted all clients with existing appointments to explain the new process, and posted a description of the process in the clinic.
Data Collection Forms
Repeat this series of steps to increase the number of counselors and time slots until you are serving your targeted number of walk-in clients.
Connecticut Renaissance, Inc. in Bridgeport, Connecticut eliminated the waiting time for assessments by offering walk-in assessments from 10 a.m. to 6:30 p.m. Tuesdays and Thursdays and 9 a.m. to 12 p.m. on Wednesdays and Fridays. The program director informed the three major referral sources about the new process to expedite admissions to outpatient treatment.
Gateway to Prevention and Recovery in Shawnee, Oklahoma eliminated the waiting time for assessments (from 14 days) and eliminated their backlog of clients by implementing walk-in assessments. Callers are encouraged to come for assessment on the day they call, or the next day. Assessment appointments are now made only when required by contract or by the caller’s special needs. Counselors have protected time to perform assessments. Support staff has been instructed to offer assessment appointments within one working day of the request. They learned that it’s important to provide clear instructions to the support staff and counselors about new processes; if the instructions aren’t clear, the staff tends to come up with their own interpretation.
Kentucky River Community Care in Jackson, Kentucky reduced the waiting time for the next available appointment from 21 days to one day by offering same-day/next-day appointments and by establishing specific times each day in the morning and the evening for new admissions. The appointment scheduler noted that most clients declined the next-day appointment and scheduled an appointment that was most convenient for them instead.
Southwest Florida Addiction Services in Fort Meyers, Florida reduced the waiting time for assessments from 35 days to 7 days by offering walk-in assessments from 11 a.m. to 3 p.m. Monday through Thursday. With this reduction in waiting time, assessments increased from 112 per month to 122 per month, the average outpatient census increased from 269 to 296 clients per month, and revenue increased 7 percent in the first year and another 7 percent at the beginning of the second year. In addition, other programs—detoxification, prevention, etc.—can now transition their clients to outpatient services more quickly.
Acadia Hospital in Bangor, Maine eliminated no-shows for assessment appointments by implementing next-day assessments. They now ask clients to come in at 7:30 a.m. on the next day for evaluation. This change resulted in $400,000 in additional revenue per year and eliminated the need to remind clients about assessment appointments. For more information, see the Acadia business case.
Heartland Family Services in Council Bluffs, Iowa reduced the waiting time for assessments from 22 days to 5 days by scheduling walk-in assessments from 1-4 p.m. on Mondays and Thursdays and from 9:30 a.m. to 12:30 p.m. on Tuesdays and Wednesdays. This decreased the no-show rate from 81 percent to 19 percent and increased the percentage of clients that paid their fees at the time of service from 66 to 86 percent. In order to smooth the transition to walkin assessments, they set the date for the switch three weeks in the future, when there were not yet any clients scheduled for assessments. For more information, see Heartland’s case study.