HealthFull Nurse-Run Clinic: Table 6.2 analyzes appointments that are lost (cannot be scheduled) because of limits to capacity. However, another problem at HealthFull Clinic is cancelled appointments, often because patients forget or cannot arrange transportation. Currently, the cancellation rate, calculate as the number of cancellationsumber of scheduled appointments over the same time period (Ehrenfeld, et al., 2013) is 30 percent. The telephone “check-in” would include appointment reminders and offers to arrange transportation, thus reducing cancellations.

a. HealthFull Clinic currently serves an estimated 400 clients. The DNP estimates 20 minutes per phone call. How much staff time would the DNP budget for this program per month? Would the DNP consider hiring staff to support this program?

b. The DNP prepares a SWOT analysis as a step in making the business case for the telephone “check-in” program. Brainstorm at least one strength, weakness, opportunity or threat that might be included in the SWOT analysis.

c. What data would the DNP use to analyze the financial impact of cancellations?

d. In 2021, 2,880 clinic visits were scheduled, and this is expected to remain the same for 2022. What calculations would the DNP make to analyze the financial impact of reducing the 2021 30% cancellation rate to 20% in 2022?

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TABLE 6.2 Utilization and Revenue Report, HealthFull Clinic, June 2021 June 2021 2021 YTD Item Referrals Appointments requested Appointments scheduled Lost appointments Total Encounters Lost revenue from capacity limits Wait Time (minutes) Patients leave without rescheduling Budgeted Actual 83 292 240 52 217 $5,200 60 240 240 0 240 $0 15.0 0 Lost revenue from excess wait $0 time Total Lost Revenue Total encounters $0 240 $24,000 0.0% $100 23.4 23 Budgeted Actual 381 1,342 1,268 74 360 1,440 1,440 0 1,440 $0 15.0 0 $2,300 $0 $7,500 263 $21,700 9.6% 0.0% $100 $100 $0 720 $144,000 1,157 $7,400 18.7 111 2020 YTD Budgeted Actual 165 626 626 0 626 $0 360 1,440 1,440 0 1,440 $0 15.0 0 $11,100 $0 $18,500 $0 1,379 720 $115,700 $144,000 19.7% 0.0% $100 $100 5.2 0 $0 $77,400 626 $62,600 56.5% $100 Estimated Net Revenue Percent Revenue Shortfall Average net revenue per encounter Note: Appointment requests exceeded capacity in April 2021 (257), May 2021 (266), and June 2021 (271).