Trial Outcomes & Findings for Reducing VA No-Shows: Evaluation of Predictive Overbooking Applied to Colonoscopy (NCT NCT01639443)

NCT ID: NCT01639443

Last Updated: 2018-04-12

Results Overview

Investigators' primary objective will be to evaluate the impact of no-show predictive overbooking on percentage of the GI endoscopy clinic that are filled on a given day. Days where at least one Fast-tracked patient attended an appointment were compared to days where only Control patients attended appointments. Percentage of GI Clinic Capacity is calculated as the number of appointments completed divided by number of appointment spots available on a given day. This percentage was compared between Fast-tracked days and Control days, using data from 1672 patients.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

180 participants

Primary outcome timeframe

After 12 months of running study in clinic

Results posted on

2018-04-12

Participant Flow

Participant milestones

Participant milestones
Measure
Fast-tracked
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.
Control
Patients who are scheduled routinely
Overall Study
STARTED
180
4855
Overall Study
COMPLETED
180
4855
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Reducing VA No-Shows: Evaluation of Predictive Overbooking Applied to Colonoscopy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fast-tracked
n=180 Participants
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.
Control
n=4855 Participants
Patients who are scheduled routinely
Total
n=5035 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
112 Participants
n=5 Participants
2812 Participants
n=7 Participants
2924 Participants
n=5 Participants
Age, Categorical
>=65 years
68 Participants
n=5 Participants
2043 Participants
n=7 Participants
2111 Participants
n=5 Participants
Age, Continuous
59.3 years
STANDARD_DEVIATION 13.6 • n=5 Participants
62.2 years
STANDARD_DEVIATION 10.0 • n=7 Participants
62.1 years
STANDARD_DEVIATION 10.1 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
206 Participants
n=7 Participants
218 Participants
n=5 Participants
Sex: Female, Male
Male
168 Participants
n=5 Participants
4649 Participants
n=7 Participants
4817 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
17 Participants
n=5 Participants
565 Participants
n=7 Participants
582 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
163 Participants
n=5 Participants
4290 Participants
n=7 Participants
4453 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants
n=5 Participants
35 Participants
n=7 Participants
37 Participants
n=5 Participants
Race (NIH/OMB)
Asian
5 Participants
n=5 Participants
109 Participants
n=7 Participants
114 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
2 Participants
n=5 Participants
28 Participants
n=7 Participants
30 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
70 Participants
n=5 Participants
1584 Participants
n=7 Participants
1654 Participants
n=5 Participants
Race (NIH/OMB)
White
83 Participants
n=5 Participants
2414 Participants
n=7 Participants
2497 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
2 Participants
n=5 Participants
41 Participants
n=7 Participants
43 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
16 Participants
n=5 Participants
644 Participants
n=7 Participants
660 Participants
n=5 Participants
Region of Enrollment
United States
180 participants
n=5 Participants
4855 participants
n=7 Participants
5035 participants
n=5 Participants

PRIMARY outcome

Timeframe: After 12 months of running study in clinic

Population: These 1672 patients are a subset of all patients who were enrolled in this study. We dropped data on a first wave of participants (69 Fast-tracked and 3294 Controls) because of problems incorporating recruitment strategy into clinic. However, data from these individuals was used to build predictive model.

Investigators' primary objective will be to evaluate the impact of no-show predictive overbooking on percentage of the GI endoscopy clinic that are filled on a given day. Days where at least one Fast-tracked patient attended an appointment were compared to days where only Control patients attended appointments. Percentage of GI Clinic Capacity is calculated as the number of appointments completed divided by number of appointment spots available on a given day. This percentage was compared between Fast-tracked days and Control days, using data from 1672 patients.

Outcome measures

Outcome measures
Measure
Fast-tracked
n=111 Participants
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.
Control
n=1561 Participants
Patients who are scheduled routinely
Percentage of GI Clinic Capacity Filled
99.6 percentage of clinic capacity filled
Standard Deviation 19.4
86.4 percentage of clinic capacity filled
Standard Deviation 21.6

SECONDARY outcome

Timeframe: After 12 months of running study in clinic

Population: These 1672 patients are a subset of all patients who were enrolled in this study. We dropped data on a first wave of participants (69 Fast-tracked and 3294 Controls) because of problems incorporating recruitment strategy into clinic. However, data from these individuals was used to build predictive model.

The investigators will calculate the mean daily lag time for all colonoscopy and upper endoscopies performed per day

Outcome measures

Outcome measures
Measure
Fast-tracked
n=111 Participants
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.
Control
n=1561 Participants
Patients who are scheduled routinely
Scheduling-to-procedure Lag Time
8.3 days
Standard Deviation 24.3
10.8 days
Standard Deviation 24.0

SECONDARY outcome

Timeframe: After 12 months of running study in clinic

Population: These 1672 patients are a subset of all patients who were enrolled in this study. We dropped data on a first wave of participants (69 Fast-tracked and 3294 Controls) because of problems incorporating recruitment strategy into clinic. However, data from these individuals was used to build predictive model.

The investigators will compare the number of patients bumped per day between scheduling approaches

Outcome measures

Outcome measures
Measure
Fast-tracked
n=111 Participants
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.
Control
n=1561 Participants
Patients who are scheduled routinely
Daily Service Denials ("Bumps")
0 participants
29 participants

SECONDARY outcome

Timeframe: After 20 months of running study in clinic

Population: We only collected data on polyp detection for the first half of our Fast-tracked participants and all Controls seen over the same time period (4897 in total).

The investigators will compare daily advanced adenomatous polyp detection and daily cecal intubation rates between groups.

Outcome measures

Outcome measures
Measure
Fast-tracked
n=90 Participants
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.
Control
n=4807 Participants
Patients who are scheduled routinely
Advanced Adenoma Detection/Cecal Intubation Rates
2.35 Number of Polyps Detected per patient
Standard Deviation 1.58
2.88 Number of Polyps Detected per patient
Standard Deviation 2.56

SECONDARY outcome

Timeframe: After 12 months of running study in clinic

Population: These 1672 patients are a subset of all patients who were enrolled in this study. We dropped data on a first wave of participants (69 Fast-tracked and 3294 Controls) because of problems incorporating recruitment strategy into clinic. However, data from these individuals was used to build predictive model.

Length of Workday in hours (comparing days with Fast-Tracked Appointments to Control days without)

Outcome measures

Outcome measures
Measure
Fast-tracked
n=111 Participants
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.
Control
n=1561 Participants
Patients who are scheduled routinely
Length of Workday
8.31 hours
Standard Deviation 1.32
7.84 hours
Standard Deviation 1.32

SECONDARY outcome

Timeframe: After 12 months of running study in clinic

Population: These 1672 patients are a subset of all patients who were enrolled in this study. We dropped data on a first wave of participants (69 Fast-tracked and 3294 Controls) because of problems incorporating recruitment strategy into clinic. However, data from these individuals was used to build predictive model.

For cost comparisons, the investigators will aggregate total provider overtime costs for colonoscopies performed. Cost is reported per day.

Outcome measures

Outcome measures
Measure
Fast-tracked
n=111 Participants
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.
Control
n=1561 Participants
Patients who are scheduled routinely
Cost Comparisons
63.01 dollars
Standard Deviation 107.01
36.88 dollars
Standard Deviation 101.73

Adverse Events

Fast-tracked

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Jennifer Talley Soares

West Los Angeles VA / Cedars-Sinai Medical Center

Phone: (310) 478-3711

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place