Overview

This trial is active, not recruiting.

Condition colon cancer
Treatment predictive no-show overbooking
Sponsor VA Office of Research and Development
Start date July 2013
End date July 2015
Trial size 180 participants
Trial identifier NCT01639443, 1I01HX000878-01, IIR 12-055

Summary

In this research study, investigators use colonoscopy as a case example to evaluate a predictive overbooking model derived using patient-level predictors of absenteeism. The no-show overbooking intervention employs a logistic regression model that uses patient data to predict the odds of no-showing with 80% accuracy. These projected no-show appointments will be overbooked by clerks for patients who agree to join a "fast track" short-call line. By rapidly processing endoscopy patients and moving them out of traditional slots, investigators predict more scheduling slots would become available for patients awaiting colonoscopy.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model parallel assignment
Masking open label
Primary purpose health services research
Arm
(Experimental)
Patients who volunteer to enroll in "fast-track" line, which gives them an opportunity to overbook their appointment for endoscopy earlier in a predictive no-show slots.
predictive no-show overbooking
During intervention period, every Veteran scheduled for an upper endoscopy will be offered "fast-track" offer, which gives them a chance to get their endoscopy procedure done earlier than usual scheduling by overbooking their appointment in a predictive no-show slot.
(No Intervention)
Patients who are scheduled routinely

Primary Outcomes

Measure
Percent capacity
time frame: After 24 months

Secondary Outcomes

Measure
Scheduling-to-procedure lag time
time frame: After 8 months
Daily service denials ("bumps")
time frame: After 8 months
Advanced adenoma detection/Cecal intubation rates
time frame: After 8 months
Daily withdrawal time
time frame: After 8 months
Cost comparisons
time frame: After 24 months

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Patients who are scheduled for upper endoscopy and agree to the terms of "fast track" offer. Exclusion Criteria: - If a patient expresses concern about service denial, confusion about the bargain, or refuses to participate, the investigators will schedule these patients routinely.

Additional Information

Official title Reducing VA No-Shows: Evaluation of Predictive Overbooking Applied to Colonoscopy
Principal investigator Paul G. Shekelle, MD PhD MPH
Description Patient "no-shows" are especially common in VA gastrointestinal (GI) endoscopy units, where both open-access endoscopy scheduling and patient dislike of procedures contribute to high absenteeism. In this proposal, investigators use endoscopy as a case example to evaluate a predictive overbooking model derived using patient-level predictors of absenteeism. The no-show overbooking intervention employs a logistic regression model that uses patient data to predict the odds of no-showing with 80% accuracy. These projected no-show appointments will be overbooked by clerks for patients who agree to join a "fast track" short-call line. However, patients scheduled for upper endoscopies in the "fast track" assume a small risk of service denial on the day of their overbooking in case of inaccurate predictions. If this occurs, the patient is guaranteed service in the next available position and is assured of having a shorter wait time. Patients scheduled for colonoscopies will never be turned down but may experience delays in the waiting room the day of their "fast track" appointment. By rapidly processing endoscopy patients and moving them out of traditional slots, investigators predict more scheduling slots would become available for patients awaiting colonoscopy. Investigators propose to conduct a prospective, 24-month, interrupted time series (ITS) trial in the WLAVA GI clinic endoscopy unit. During intervention periods, investigators will activate the no-show predictive overbooking strategy described above. Investigators will compare outcomes between scheduling strategies, including differences in percent utilization of capacity (primary outcome), number of Veterans served, mean patient lag time between scheduling and procedure, number of unexpected service denials ("bumps") from no-show predictive overbooking, and direct costs of care. Investigators will analyze differences using both traditional univariate and multivariate approaches, and using autoregressive integrated moving average (ARIMA) analyses to adjust for auto-correlations in ITS data.
Trial information was received from ClinicalTrials.gov and was last updated in January 2016.
Information provided to ClinicalTrials.gov by VA Office of Research and Development.