If we proceed with the plan of building that rapport with the adjs around the base, starting off

with those associated with CDU B, whom ever will be responsible for the notifications (or even
us) can send a email to the adjs to let them know the plan, and we have the full backing of the
CO LCdr MacIsaac. But I firmly believe that if we have the few people directly handling the
reminders keep in contact that with the adj, and have them explain the situation and the game
plan, most of them should be pretty understanding. This can go one of two ways, best case
scenario we advise the adjs, and they push the notification down their respective chain so they
are on top of it. Worst case scenario they don’t , but we’ll have their “read receipt” from
DWAN, and if anyone should say they weren’t notified, we can say we done due diligence.

1. What is the verification process to identify and confirm missed appointments?  If a letter
goes to the chain of command and we have made an error internally, we risk losing
credibility.

This is where going through the adj helps. We can be sure the Adj has access to email.
So if we generate a list once a month say saying who has an appointment and when, once
they open that email it should generate a read receipt on our end. We can suggest that
they distribute the notification appropriately, but more we can just say that these emails
are to bridge communication between 42 Health and the units, so when members do
become regular no shows, the CoC are not blindsided.

Because of the issue unless we email the members on their own DWAN, which we
established that the status quo usually do have regular access to, neither civi email or
phone call will generate a read receipt. So in a dispute it becomes a he said she said. But
if the adj is involved, we can at least partly cover our ass.

2. Would there be value to additional information/education about missed appointments?

I think there should be some posters and maybe emails sent out about the cost of missed
appointments. Some emails/posters should stipulate the cost of missed appointments, but
I think if we focus on how many appointments are missed per week, and subsequently
the time it takes to rebook an appointment, it may emphasize the situation. The other
aspect of this if that “punishment” aspect we can possible put in. I know we talked about
a fine like some other organization, and the JPSU WO doesn’t see that as a feasible
option, but what we could do is say, “if you miss 3 appointments, you have to book the
appointment in person”, as well as their CoC being informed. However, with any PSA,
it’s not going to be a game changer, but for the price of a few posters and a mass email, I
don’t think it can hurt.

3. Is there an existing SOP?  If so, do you anticipate a revision being included in the
project?

There are no SOPs at the clinic. The dental assistants do it personally for their
respective dentists, however I don’t think it works for us. Not sure what the other units
are doing like the one in Valcartier.
 4. In developing the process map, who do you plan on engaging?  Is there value to
including other organizations, such as Dental?

As it stands, the more moving parts we involve the longer its going to take. End of the
day we cant completely eliminate missed appointments. If we can keep it small to CDU
B, whether the whole CDU or a small sample population and can see a notable change, it
is something we can employ on a bigger scale. But as it stands, I think we should keep it
to CDU B, and just involve the associated adjs.

5. What are the workload implications?  How can they be mitigated?

The sample population size will depend on the manpower we have. It is ideal to
maintain the initiative amongst clinical staff to ensure continuity after the project.
Therefore depending on the current manpower availability it could vary from a sample
population of 10-20 appointments to an entire CDU. Once the system has been
established and has shown positive results, there are automated reminder services or
software available.

http://health.sunnybrook.ca/navigator/patients-pay-miss-doctor-appointment/

http://montrealgazette.com/news/local-news/new-medical-app-helps-montreal-patients-get-a-
doctors-appointment

http://www.medscape.com/viewarticle/712367_3

https://www.appointmentreminder.org/pricing