BOOKS OF RtfiDIfGS - PAHO/WHO

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have the opportunity to conr:',: a physician about difficult situations.
For both routine and non-routine triaging situations, a questionnaire
could be developed to be completed by the patient,
which would provide a means for systematic evaluation of triaging
accuracy. On the ba;-s of this questionnaire, an appointment
could be changed at the discretion of the Physician Triage Officer
or any other medical staff.
For multiple appointments, the appointment processing area
will make a triage (with the help of the Physician Triage Officer
when necessary). Then the area will call the proper deE!;z and
coordinate the appointments. This coordination will be made
easily becau,e all appointment availabilities will be known at the
appointment processing area. In tl.e new system, the problem of
excessive transferring of calls fromr department to departrnent
will be avoided.
A major problem for the clinic was that of no-shows. 7 However,
many of these no-shows are predictable. For example, a
patient with multiple appointments may call his primary department
to say that he will not be able to make this appointment.
The primary department appointment will be cancelled;
however, often the person making the cancellation does not
know about the other appointments for that day. These appointments
will not be cancelled and will result in no-shows. This
situation can bei avoided in the recommended system since,
whenever a patient cancels an appointment, all other appointments
can easily be checked in the scheduled appointment file.
Part of the updating procedure in the appointment processing
area could be to check in this file (urnder the patient's name) for
additional appointments for the same day or associated, in some
way, with the cancelled appointmentS.
A predictable no-show can also occur when . a patient with an
appointment scheduled sometime in the future has an appointment
with the same doctor at an earlier date. This often happens
due to a change in medical urgency for the patient. In the present
'The billings foregone due to patient no-shows are estimated to be in the $1,000,000 to
$2.000,000 range per year.