2020 Vision: What Will You Improve in the New Year?

Walk-ins
“The best way to get rid of no-shows for appointments is to get rid of appointments.”
As a coach, I often work with behavioral health organizations that are struggling with low show rates. The result is low staff productivity, reduced revenue generation, client turnover, increased costs associated with higher discharge and admission rates, and a felt failure to perform the core service mission of supporting individuals through the recovery process.

Programs often choose to work on a range of strategies designed to increase show rates. They use incentives for clients and staff, reminder calls, and transportation supports to get more clients to the door at the designated hour. But too often these efforts yield only modest results. That is when I often make the bold assertion above, and usually couple it with the following question:

Why do we think that appointments will work when we are serving people who do not schedule appointments for any other service that they receive?
The introduction of developing a walk-in approach often yields a great deal of anxiety…

• But we won’t be able to plan our day?
• We will have no way of knowing who will show up?
• How will we staff for this?

In response to these concerns, I typically ask a question or two:

• How do emergency rooms do it?
• How do grocery stores do it?

This is the moment when many teams began to shift their thinking toward a new paradigm: Maybe we could find ways to reorganize ourselves with walk-ins. Perhaps we could do some short walk-in periods during the week to explore the model. Maybe this will create better service access. If a grocery store can do, we can too.

Walk-ins don’t work for everybody, but they do work for many. And they are a great way for traditional programs to rethink how they deliver care.

See the NIATx Promising Practice: Establish Walk-in Hours

About our Guest Blogger Mat Roosa was a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant in the areas of quality improvement, organizational development, and planning, evidence-based practice implementation. He also serves as a local government planner in behavioral health in New York State. His experience includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human service agency administration. You can reach Mat at [email protected]