How to manage late appointments at a research lab?
November 20, 2017 9:57 AM Subscribe
I work in a research lab that has families come in for studies. We're in a metro area with LOADS of transit options and we have free parking available nearby to our participants. Our provided directions are very good (I think). Despite all this, at least 20% of our participants arrive later than our late cut-off time.
First off, I understand that being a parent is inherently stressful and things always run behind. We are otherwise VERY flexible, and I don't care at all about last minute cancellations or rescheduling. I don't even care that much about no-shows. And I WILL take people later than 20 minutes, if our schedule allows.
We're clear about our 20-minute late policy. Unfortunately though, our sessions often take a full hour, so even when a parent is 20 minutes late it means that the next parent (who likely is not late) will be made to wait.
Our very good directions consist of our address, the nearest intersection and nearby landmarks, the address of the parking garage (and a google maps link), pictures of our building, and information about what to do once you arrive at our building. This is written in our appointment email. We also attach a 2-page PDF document that has more in-depth directions and photos, transit options and driving directions.
I get parents who are either VERY BAD at estimating how late they will be or are simply untruthful about it. So, for example, a parent may call at 12:05 and say they are 5 or 10 minutes away. I'll tell them that's OK, but remind them that if they are more than 20 minutes late, we will need to reschedule. Then, about 50% of the time, they will not be there within 20 minutes of their appointment time. Recently, I had a participant show up 45 minutes late and was indignant that I could no longer do the study with them, despite multiple warnings about our 20 minute policy and several unanswered phone calls from me.
I'm at my wit's end figuring out how to solve this situation. I've considered buffering our appointments by 15-30 minutes, but that reduces the number of appointments that we can do in the day and the amount of data we collect.
Any suggestions as to what we can do to make this more clear? Should we tell people their appointment is 15 minutes later than it is? Should I give up and set 30 minutes buffers between sessions? Better directions? Better emails? I'm lost and desperate. Thanks!
First off, I understand that being a parent is inherently stressful and things always run behind. We are otherwise VERY flexible, and I don't care at all about last minute cancellations or rescheduling. I don't even care that much about no-shows. And I WILL take people later than 20 minutes, if our schedule allows.
We're clear about our 20-minute late policy. Unfortunately though, our sessions often take a full hour, so even when a parent is 20 minutes late it means that the next parent (who likely is not late) will be made to wait.
Our very good directions consist of our address, the nearest intersection and nearby landmarks, the address of the parking garage (and a google maps link), pictures of our building, and information about what to do once you arrive at our building. This is written in our appointment email. We also attach a 2-page PDF document that has more in-depth directions and photos, transit options and driving directions.
I get parents who are either VERY BAD at estimating how late they will be or are simply untruthful about it. So, for example, a parent may call at 12:05 and say they are 5 or 10 minutes away. I'll tell them that's OK, but remind them that if they are more than 20 minutes late, we will need to reschedule. Then, about 50% of the time, they will not be there within 20 minutes of their appointment time. Recently, I had a participant show up 45 minutes late and was indignant that I could no longer do the study with them, despite multiple warnings about our 20 minute policy and several unanswered phone calls from me.
I'm at my wit's end figuring out how to solve this situation. I've considered buffering our appointments by 15-30 minutes, but that reduces the number of appointments that we can do in the day and the amount of data we collect.
Any suggestions as to what we can do to make this more clear? Should we tell people their appointment is 15 minutes later than it is? Should I give up and set 30 minutes buffers between sessions? Better directions? Better emails? I'm lost and desperate. Thanks!
So, maybe you need more data....
When folks are late, get them to complete a short form. Preface it with, 'We understand being late happens, but X and Y is the implications' We would like to help reduce late appointments for X and Y reasons. Can you help us understand why you were late. Ticky boxes with common reasons. Write in space. Very non judgemental language. And then ask for their ideas. What would help? Better directions? Reminder call day before? Better estimate of drive/transit times from common starting points? Better waiting area so folks aren't afrif of being early? Again, non judgemental language and room for write ins.
Then see what the answers are and try to facilitate fixing those issues.
posted by Northbysomewhatcrazy at 10:05 AM on November 20, 2017 [11 favorites]
When folks are late, get them to complete a short form. Preface it with, 'We understand being late happens, but X and Y is the implications' We would like to help reduce late appointments for X and Y reasons. Can you help us understand why you were late. Ticky boxes with common reasons. Write in space. Very non judgemental language. And then ask for their ideas. What would help? Better directions? Reminder call day before? Better estimate of drive/transit times from common starting points? Better waiting area so folks aren't afrif of being early? Again, non judgemental language and room for write ins.
Then see what the answers are and try to facilitate fixing those issues.
posted by Northbysomewhatcrazy at 10:05 AM on November 20, 2017 [11 favorites]
Well you have their addresses, and perhaps the address of the school the child attends, run an automated estimate of travel time for them.
Send an automated message to "auto cancel" at the 30 minute mark prior to the appointment. Hopefully that will mostly give a nudge.
posted by sammyo at 10:07 AM on November 20, 2017 [2 favorites]
Send an automated message to "auto cancel" at the 30 minute mark prior to the appointment. Hopefully that will mostly give a nudge.
posted by sammyo at 10:07 AM on November 20, 2017 [2 favorites]
You refer to "studies." Is this academic research, such that the families are volunteers? Then you can expect things to be a little loosey-goosey since there's no downside to their lateness. Consider paying them, but only if they're satisfactorily punctual.
Or are your studies something that the families want or need? In that case, have them pay in advance, and no refunds given if they're late. And charge more. Second offense, fire them for their lateness. Life's too short.
posted by JimN2TAW at 10:08 AM on November 20, 2017 [7 favorites]
Or are your studies something that the families want or need? In that case, have them pay in advance, and no refunds given if they're late. And charge more. Second offense, fire them for their lateness. Life's too short.
posted by JimN2TAW at 10:08 AM on November 20, 2017 [7 favorites]
Are these people who will come to your lab only once? Or are you seeing the same people again and again? I think you may just need to stop being so lenient. An appt time is an appt time. If they know it's appt time + 20 minutes or "appt time" (= any time they show up) then they're just going to come in whenever they want.
"While we will do our best to accommodate clients who are running late, please be aware that we cannot accept anyone who arrives 15 minutes after their appt time." And then stick to it. If they call then say, "That's fine, if you're here by X:20 - but if not I will have to reschedule you, I have no choice".
Beefing up directions and giving a call the day before certainly will help a bit but in the end, you have an appt system and you need to stick with it.
posted by dawkins_7 at 10:09 AM on November 20, 2017 [2 favorites]
"While we will do our best to accommodate clients who are running late, please be aware that we cannot accept anyone who arrives 15 minutes after their appt time." And then stick to it. If they call then say, "That's fine, if you're here by X:20 - but if not I will have to reschedule you, I have no choice".
Beefing up directions and giving a call the day before certainly will help a bit but in the end, you have an appt system and you need to stick with it.
posted by dawkins_7 at 10:09 AM on November 20, 2017 [2 favorites]
Is this something that people only do once, or something that involves repeat appointments? Also have you tried asking people to show up 15 minutes early (to do paperwork, or whatever) so that they know showing up early is both OK and desirable?
Ultimately, though, some people are going to be late, and honestly 20 minutes is not that late (I mean, as a punctual person it hurts me to say it, but that's the truth for a lot of people). Building more buffer time into the schedule is probably the only way around it. I mean depending on what kinds of studies you're doing you probably want babies from diverse backgrounds, including the babies of chronically late parents!
Without knowing more about what you're doing, it's hard to make a concrete suggestion as to how to work the timing, but my main suggestion would be to try to have two parts to the appointment: a core part that is what you actually need to happen, and an non-time-sensitive part that the parent can do either independently or with the help of the least-busy person in the lab, either before or after the core part of the appointment.
posted by mskyle at 10:16 AM on November 20, 2017 [1 favorite]
Ultimately, though, some people are going to be late, and honestly 20 minutes is not that late (I mean, as a punctual person it hurts me to say it, but that's the truth for a lot of people). Building more buffer time into the schedule is probably the only way around it. I mean depending on what kinds of studies you're doing you probably want babies from diverse backgrounds, including the babies of chronically late parents!
Without knowing more about what you're doing, it's hard to make a concrete suggestion as to how to work the timing, but my main suggestion would be to try to have two parts to the appointment: a core part that is what you actually need to happen, and an non-time-sensitive part that the parent can do either independently or with the help of the least-busy person in the lab, either before or after the core part of the appointment.
posted by mskyle at 10:16 AM on November 20, 2017 [1 favorite]
I work in a medical practice where people are often coming from one or two hours away, so I hear you. We do automated reminders with an arrival time 15 minutes before the appointment time. And our late arrival policy is 15 minutes or 30 minutes (I'll confirm). After that we ask the provider if they can fit the patient in but often they say no. Then we reschedule them.
posted by emkelley at 10:17 AM on November 20, 2017 [2 favorites]
posted by emkelley at 10:17 AM on November 20, 2017 [2 favorites]
Well, your late subjects already reducing the number of appointments you can do in a day.
First, are you collecting data about which times of day and days of the week/month the appointments tend to be late? Like, actually collecting the data of check in time against scheduled time? If not, start doing that.
While you're doing that, develop a script for scheduling staff to use. Key words are "reserved just for you" and "the doctor (or other title) is available at." Limit the number of times offered to each potential subject, rather than asking "when is good for you?" (one suggests that the time is at a premium, the other suggests, we're at your whim here") Record responses. Have the scheduling staff be very specific about how long the study takes.
Next, put a google map link on your site, with your site address pre populated so that participants just need to enter their starting address and they can see how long transit will take. You can also, as a courtesy, include this information in a courtesy email to your participants. They can tell your scheduler the likely mode of transportation on the call, so you can let them know about parking. Again, this call needs to be scripted and responses recorded. "Google maps estimates that with traffic, your driving/transit time from _child's school/your office/your home_ will be approximately ___ minutes. Please take traffic delays into consideration. Our whole team is looking forward to seeing you at ___"
Use the words "courtesy message" rather than "reminder" when, well, reminding subjects. Reminder means you think they forgot. Courtesy means you're generous and being on the same team, and gives you an opportunity to reinforce the value of the visit. If you are including an option to cancel, stop doing that. You are inviting them to not show/be late. If a subject needs to cancel, they will figure out how to contact your office (you've made that easy already, right?) or they'll be having such an emergency that canceling is the farthest thing from their mind. Practice scripting for "salvaging" an attempt at canceling an appointment.
As for accommodating late arrivals, empower your your reception staff to "check" with the clinical/study staff to see if they can be accommodated. Literally, have them walk to a back area, have a conversation with someone. Then if accommodation is possible (reception probably already knew it was possible, but you're adding friction to the client so that being late has some discomfort!), have the reception staff return to the front and express the good news that there has been a change in the doctor's (or title) schedule and the participant can be seen today. This sets this up not only as an act of generosity, but as good fortune, making it clear that another lateness may not be accommodated. If there is no accommodation to be made, thank the participant for attempting to arrive on time (because they probably did try), and offer to brainstorm ways to help them succeed next time.
Getting people to be on time in a professional setting is...one of my office super powers. Feel free to me mail me if you need more guidance.
Also, I'd be really curious to see if lateness has sooooome correlation with something that you're studying.
So. TL;DR:
1. collect all the data about when this is happening, make adjustments for that (dates/times/bus vs car/days of week/month/Weather!) If your 4:00 Friday appointment is always late, then figure out a way to make that slot "longer" by having it go to 5:15 instead of 5:00, or whatever.
2. script initial conversations to prevent lateness
3. encourage subjects to think about and plan for travel time, during the phone call and subsequent contacts
4. script courtesy notices to encourage timeliness
5. script late arrivals to reinforce future timeliness
This is going to involve a lot of very uncomfortable role play for everyone in your office. Everyone needs to be involved. Everyone needs to practice. It will feel really dumb and stupid and pointless and controlling for the first few months. But I promise you it will help.
posted by bilabial at 10:24 AM on November 20, 2017 [22 favorites]
First, are you collecting data about which times of day and days of the week/month the appointments tend to be late? Like, actually collecting the data of check in time against scheduled time? If not, start doing that.
While you're doing that, develop a script for scheduling staff to use. Key words are "reserved just for you" and "the doctor (or other title) is available at." Limit the number of times offered to each potential subject, rather than asking "when is good for you?" (one suggests that the time is at a premium, the other suggests, we're at your whim here") Record responses. Have the scheduling staff be very specific about how long the study takes.
Next, put a google map link on your site, with your site address pre populated so that participants just need to enter their starting address and they can see how long transit will take. You can also, as a courtesy, include this information in a courtesy email to your participants. They can tell your scheduler the likely mode of transportation on the call, so you can let them know about parking. Again, this call needs to be scripted and responses recorded. "Google maps estimates that with traffic, your driving/transit time from _child's school/your office/your home_ will be approximately ___ minutes. Please take traffic delays into consideration. Our whole team is looking forward to seeing you at ___"
Use the words "courtesy message" rather than "reminder" when, well, reminding subjects. Reminder means you think they forgot. Courtesy means you're generous and being on the same team, and gives you an opportunity to reinforce the value of the visit. If you are including an option to cancel, stop doing that. You are inviting them to not show/be late. If a subject needs to cancel, they will figure out how to contact your office (you've made that easy already, right?) or they'll be having such an emergency that canceling is the farthest thing from their mind. Practice scripting for "salvaging" an attempt at canceling an appointment.
As for accommodating late arrivals, empower your your reception staff to "check" with the clinical/study staff to see if they can be accommodated. Literally, have them walk to a back area, have a conversation with someone. Then if accommodation is possible (reception probably already knew it was possible, but you're adding friction to the client so that being late has some discomfort!), have the reception staff return to the front and express the good news that there has been a change in the doctor's (or title) schedule and the participant can be seen today. This sets this up not only as an act of generosity, but as good fortune, making it clear that another lateness may not be accommodated. If there is no accommodation to be made, thank the participant for attempting to arrive on time (because they probably did try), and offer to brainstorm ways to help them succeed next time.
Getting people to be on time in a professional setting is...one of my office super powers. Feel free to me mail me if you need more guidance.
Also, I'd be really curious to see if lateness has sooooome correlation with something that you're studying.
So. TL;DR:
1. collect all the data about when this is happening, make adjustments for that (dates/times/bus vs car/days of week/month/Weather!) If your 4:00 Friday appointment is always late, then figure out a way to make that slot "longer" by having it go to 5:15 instead of 5:00, or whatever.
2. script initial conversations to prevent lateness
3. encourage subjects to think about and plan for travel time, during the phone call and subsequent contacts
4. script courtesy notices to encourage timeliness
5. script late arrivals to reinforce future timeliness
This is going to involve a lot of very uncomfortable role play for everyone in your office. Everyone needs to be involved. Everyone needs to practice. It will feel really dumb and stupid and pointless and controlling for the first few months. But I promise you it will help.
posted by bilabial at 10:24 AM on November 20, 2017 [22 favorites]
The place I've done a bunch of kid's studies with have special permission with campus police for families to park in a normally no-parking spot DIRECTLY in front of the building. When you make an appointment, they say "[Undergrad] will meet you at the entrance," sometimes with a brief physical description. If any of those things are possible, they may help if the main factor is delays in getting from the parking lot to the lab, and in making the interaction more personal.
Other factors: I know that usually the parents have a form to fill out. Could you ask them to arrive 10 minutes early to fill out the form, or get the child comfortable before the test starts, or similar? I agree you should have a very short exit survey including something about lateness; even the timely folks may have useful feedback if the issue is a hard-to-reckon distance.
Lastly, I suspect that a lot of people in the world are just 20 minutes late for everything. I've had similar meetings before (not with families, but with very clearly stated times beyond which the late arrival wouldn't be able to participate), and the late folks regularly take their frustration with themselves out on staff. It sucks and I don't think there's much of a way around it.
posted by tchemgrrl at 10:56 AM on November 20, 2017 [1 favorite]
Other factors: I know that usually the parents have a form to fill out. Could you ask them to arrive 10 minutes early to fill out the form, or get the child comfortable before the test starts, or similar? I agree you should have a very short exit survey including something about lateness; even the timely folks may have useful feedback if the issue is a hard-to-reckon distance.
Lastly, I suspect that a lot of people in the world are just 20 minutes late for everything. I've had similar meetings before (not with families, but with very clearly stated times beyond which the late arrival wouldn't be able to participate), and the late folks regularly take their frustration with themselves out on staff. It sucks and I don't think there's much of a way around it.
posted by tchemgrrl at 10:56 AM on November 20, 2017 [1 favorite]
I've considered buffering our appointments by 15-30 minutes, but that reduces the number of appointments that we can do in the day and the amount of data we collect.
How many people are you losing because they are late? I.e. if you add the buffer and are then able to see all scheduled patients even if they're late, you may wind up being ahead or at least break even in the amount of data actually collected. If you wind up at least breaking even or near it, the reduced stress/headache of running behind may be worth the loss of potential data collection spots.
We tell people new to our office their arrival time is X, with X = appointment start time-15 minutes. It's for paperwork, but we don't specify that. Punctual people will then sometimes be very early, but are typically understanding about waiting.
Can the appointments be split up? I.e. if someone is 20 minutes late can half of the appointment still be done and then bring them back to complete? I've found that "doing what we can" strikes the right note of being flexible for the late ones without making punctual ones suffer. Most people are then usually on time for the follow up.
On the rare occasions I run late, I'll have my scheduler call upcoming appointments and let them know. This may or may not be feasible/useful for your population though (most of the people seeing me live 5-10 minutes from me).
Also agreeing that being so clear about the 20 minutes grace period could be causing more problems. I'd remove the explicit time frame for a more generic "Late arrivals cannot always be accommodated and may need to be rescheduled," or a softer version of that.
posted by ghost phoneme at 10:58 AM on November 20, 2017
How many people are you losing because they are late? I.e. if you add the buffer and are then able to see all scheduled patients even if they're late, you may wind up being ahead or at least break even in the amount of data actually collected. If you wind up at least breaking even or near it, the reduced stress/headache of running behind may be worth the loss of potential data collection spots.
We tell people new to our office their arrival time is X, with X = appointment start time-15 minutes. It's for paperwork, but we don't specify that. Punctual people will then sometimes be very early, but are typically understanding about waiting.
Can the appointments be split up? I.e. if someone is 20 minutes late can half of the appointment still be done and then bring them back to complete? I've found that "doing what we can" strikes the right note of being flexible for the late ones without making punctual ones suffer. Most people are then usually on time for the follow up.
On the rare occasions I run late, I'll have my scheduler call upcoming appointments and let them know. This may or may not be feasible/useful for your population though (most of the people seeing me live 5-10 minutes from me).
Also agreeing that being so clear about the 20 minutes grace period could be causing more problems. I'd remove the explicit time frame for a more generic "Late arrivals cannot always be accommodated and may need to be rescheduled," or a softer version of that.
posted by ghost phoneme at 10:58 AM on November 20, 2017
Response by poster: To answer a few questions:
These folks are paid research subjects who are coming in for one-time research sessions. They have the option to come back for other, unrelated research sessions. (They are related in that they are involving the same subject area but the studies aren't connected).
In the past, I've tried to be more flexible, keeping in mind that they are parents and that's a stressful role as it is, but it's only worsened the issue, particularly when I have people coming back for other studies.
We are a small research lab (i.e. I'm am the "scheduling staff"), so my time is limited in terms of what I'm able to do.
I love the idea of collecting data about when people are most often late. Re: correlations with lateness: it's almost exclusively low-SES populations that have the most trouble, and for a number of completely legit reasons.
The craziest thing is that I have on a number of occasions had to remind people to use walking directions in their GPS app instead of driving directions (when they are walking from the garage or the transit stop). This seems like a no-brainer to me but this messes people up. I'm at the point where the directions portion of the email is 4 paragraphs long while the whole email is 6 paragraphs long, so adding more info seems crazy.
posted by ancient star at 11:14 AM on November 20, 2017
These folks are paid research subjects who are coming in for one-time research sessions. They have the option to come back for other, unrelated research sessions. (They are related in that they are involving the same subject area but the studies aren't connected).
In the past, I've tried to be more flexible, keeping in mind that they are parents and that's a stressful role as it is, but it's only worsened the issue, particularly when I have people coming back for other studies.
We are a small research lab (i.e. I'm am the "scheduling staff"), so my time is limited in terms of what I'm able to do.
I love the idea of collecting data about when people are most often late. Re: correlations with lateness: it's almost exclusively low-SES populations that have the most trouble, and for a number of completely legit reasons.
The craziest thing is that I have on a number of occasions had to remind people to use walking directions in their GPS app instead of driving directions (when they are walking from the garage or the transit stop). This seems like a no-brainer to me but this messes people up. I'm at the point where the directions portion of the email is 4 paragraphs long while the whole email is 6 paragraphs long, so adding more info seems crazy.
posted by ancient star at 11:14 AM on November 20, 2017
it's almost exclusively low-SES populations that have the most trouble, and for a number of completely legit reasons
Are they reasons that you could schedule around (e.g., bus schedules, work schedules)? If so, maybe try doing that. If not, I'd start telling people (all participants) an arrival time that is 15 minutes earlier than their appointment.
posted by lazuli at 11:27 AM on November 20, 2017 [1 favorite]
Are they reasons that you could schedule around (e.g., bus schedules, work schedules)? If so, maybe try doing that. If not, I'd start telling people (all participants) an arrival time that is 15 minutes earlier than their appointment.
posted by lazuli at 11:27 AM on November 20, 2017 [1 favorite]
If getting there is so complicated as to need walking GPS and paragraphs of directions, then your office is a PITA to get to, and humans of all stripes are just plain going to be late, despite their best laid plans and noble intentions. A 20-minute GTFO policy seems unrealistic in this context.
I'd go for adding some buffer, and also asking them to show up 30 minutes before you actually need them - for example, if you need them at 1200, their appointment is 1130. If they have to wait, they have to wait, and the more important thing is probably to give them a realistic idea of how long they will be there. So if the assessment takes 60 minutes, don't tell them it 60 minutes - tell them to plan to be in clinic for 2 hours.
posted by everythings_interrelated at 11:34 AM on November 20, 2017 [4 favorites]
I'd go for adding some buffer, and also asking them to show up 30 minutes before you actually need them - for example, if you need them at 1200, their appointment is 1130. If they have to wait, they have to wait, and the more important thing is probably to give them a realistic idea of how long they will be there. So if the assessment takes 60 minutes, don't tell them it 60 minutes - tell them to plan to be in clinic for 2 hours.
posted by everythings_interrelated at 11:34 AM on November 20, 2017 [4 favorites]
If they're paid research subjects, how about paying them more if they arrive on time?
posted by ShooBoo at 11:49 AM on November 20, 2017 [1 favorite]
posted by ShooBoo at 11:49 AM on November 20, 2017 [1 favorite]
Response by poster: If getting there is so complicated as to need walking GPS and paragraphs of directions, then your office is a PITA to get to, and humans of all stripes are just plain going to be late, despite their best laid plans and noble intentions. A 20-minute GTFO policy seems unrealistic in this context.
I promise you, it is not really that difficult to get to us. We're in a metro area close to a lot of things (on a college campus). The building is on the east side of the street and there is a four lane, two-way street outside. If you are walking south toward the building using driving directions, it'll tell you to go in the opposite direction because it thinks you're in a car and that you need to go north to make a u-turn.
I'm talking about 20% of people are late and maybe 5% of them used driving directions while walk and didn't realize it and ended up late.
posted by ancient star at 11:51 AM on November 20, 2017
I promise you, it is not really that difficult to get to us. We're in a metro area close to a lot of things (on a college campus). The building is on the east side of the street and there is a four lane, two-way street outside. If you are walking south toward the building using driving directions, it'll tell you to go in the opposite direction because it thinks you're in a car and that you need to go north to make a u-turn.
I'm talking about 20% of people are late and maybe 5% of them used driving directions while walk and didn't realize it and ended up late.
posted by ancient star at 11:51 AM on November 20, 2017
People are late for things. You are not doing anything wrong. It sounds like they are not doing anything wrong (except suffering from the human condition). I also work in research and have people who are late all the time. I know it is so, so frustrating in aggregate - and we even pay people or get them transportation! They are showing up late and we are giving them money to get there! But I have to remember about the time I was late because there was an accident on Ponce and I forgot I didn't get gas and that other time where I realized I left my keys in the building so had to, and... So yeah. As stated above, about 20-40% of people will just be late no matter what. Here are my thoughts.
I'm at the point where the directions portion of the email is 4 paragraphs long while the whole email is 6 paragraphs long, so adding more info seems crazy.
You need to cut that a lot shorter. Many people do not read them, and only a few will read all that and find ithelpful.
For them:
- Short directions (a recent one fit on the back of our appointment card, so business card sized - a map with a star and key locations, plus about two sentences of writing. Happy to send you a copy.) If they're not driving, information on walking from the bus/tram system could be good.
- Automated reminders / courtesy messages (might be supported or supportable by your database - I have a handy Access program that sends MMSs to phones)
For you:
- Giving more of a window - schedule people in for 90 minutes, so that when they're 20 minutes late, they can come, fill out the paperwork, and be ready to go for 60 minutes. If they have to wait, well, that's relatively standard and often better accommodated.
- Figure out why people are late. I think asking directly "why were you late?" is a little abrupt, especially when they're doing you the favor by being in the study. Instead, either directing the first staff member to record any details about finding the place, mode of transit, etc., may elicit more information about why people were late.
posted by quadrilaterals at 12:10 PM on November 20, 2017 [2 favorites]
I'm at the point where the directions portion of the email is 4 paragraphs long while the whole email is 6 paragraphs long, so adding more info seems crazy.
You need to cut that a lot shorter. Many people do not read them, and only a few will read all that and find ithelpful.
For them:
- Short directions (a recent one fit on the back of our appointment card, so business card sized - a map with a star and key locations, plus about two sentences of writing. Happy to send you a copy.) If they're not driving, information on walking from the bus/tram system could be good.
- Automated reminders / courtesy messages (might be supported or supportable by your database - I have a handy Access program that sends MMSs to phones)
For you:
- Giving more of a window - schedule people in for 90 minutes, so that when they're 20 minutes late, they can come, fill out the paperwork, and be ready to go for 60 minutes. If they have to wait, well, that's relatively standard and often better accommodated.
- Figure out why people are late. I think asking directly "why were you late?" is a little abrupt, especially when they're doing you the favor by being in the study. Instead, either directing the first staff member to record any details about finding the place, mode of transit, etc., may elicit more information about why people were late.
posted by quadrilaterals at 12:10 PM on November 20, 2017 [2 favorites]
If you tell them they are allowed to be 20 minutes late, they will think they can get away with being 20 minutes later than that. Tell them they can't be seen more than 5 minutes late, then kindly make an "exception" for people up to 20 minutes.
posted by windykites at 12:12 PM on November 20, 2017 [8 favorites]
posted by windykites at 12:12 PM on November 20, 2017 [8 favorites]
It sounds like this is a customer service problem rather than an objectives problem - you're ultimatly getting the participants you need, but you're struggling with how to deal with the ones who come late and mess things up for the rest of your day. You need to become more comfortable with saying no. Set reasonable expectations, be clear about your expectations, add in your 20 minute buffer, and then, when the 20% of people who are more than 20 minutes late arrive, put on your most sympathetic voice and say that you are oh so sorry but they simply cannot be accommodated. The key is to present yourself as very sympathetic and open but to stand firm no matter how indignant the person may be when they arrive 30 minutes late. You aren't mad at them, you aren't blaming them, but the reality of the situation means that they simply cannot be accommodated.
I say this because you say you don't care about last minute cancellations or rescheduling - so it's not as though you have unreasonable expectations or that you're going to suffer as an organization for turning away the people who come more than 20 minutes late. I work in an agency where we serve parents of babies who come in for processes that take a minimum of 45 minutes, usually longer, and whose appointments can't be extended without serious repercussions all across our operations. We do our best to accommodate, and we build in some flexibility, but if somebody comes in very (30 minutes +) late, or comes in somewhat late but hasn't prepared any of the documents we sent to them ahead of time, we just tell them to schedule another appointment. It's hard the first few times you say no but after that, the certainty of knowing what the guidelines are and how to enforce them every single time is a boon to the whole operation. Be clear, and enforce the guidelines.
posted by exutima at 12:13 PM on November 20, 2017 [1 favorite]
I say this because you say you don't care about last minute cancellations or rescheduling - so it's not as though you have unreasonable expectations or that you're going to suffer as an organization for turning away the people who come more than 20 minutes late. I work in an agency where we serve parents of babies who come in for processes that take a minimum of 45 minutes, usually longer, and whose appointments can't be extended without serious repercussions all across our operations. We do our best to accommodate, and we build in some flexibility, but if somebody comes in very (30 minutes +) late, or comes in somewhat late but hasn't prepared any of the documents we sent to them ahead of time, we just tell them to schedule another appointment. It's hard the first few times you say no but after that, the certainty of knowing what the guidelines are and how to enforce them every single time is a boon to the whole operation. Be clear, and enforce the guidelines.
posted by exutima at 12:13 PM on November 20, 2017 [1 favorite]
Could you add an orientation? This is the only thing that works for us at the library to get people to show up on time for programs where attendance on time is important. People who have already invested some time in something are less likely to abandon it later. It's more work up front but weeds out the flakes effectively.
So, you'd have a preregistration, people would show up to the orientation, you would complete most of their paperwork and brief them on the expectations, and then schedule their research appointment for a different day. It would be OK if they were late, because you can just run a "second showing" of the orientation and paperwork can be completed in waves.
After the orientation, you know that everyone has completed paperwork and that they have been to your office and know how long it takes to get there. Everyone meeting you for the actual appointment can be hustled in because you already have their documents on file, saving time if they are late anyway.
posted by blnkfrnk at 12:14 PM on November 20, 2017
So, you'd have a preregistration, people would show up to the orientation, you would complete most of their paperwork and brief them on the expectations, and then schedule their research appointment for a different day. It would be OK if they were late, because you can just run a "second showing" of the orientation and paperwork can be completed in waves.
After the orientation, you know that everyone has completed paperwork and that they have been to your office and know how long it takes to get there. Everyone meeting you for the actual appointment can be hustled in because you already have their documents on file, saving time if they are late anyway.
posted by blnkfrnk at 12:14 PM on November 20, 2017
I wonder if part of the problem, ironically, is that your emails have too much information -- when I get an email from an office and there's paragraphs of boiler-plate info pasted in, honestly, I skim it or skip it. I'm not saying it's right, or that the information you're providing isn't good, just that I personally would probably never read it. I'd assume that I have the address, and I navigate the city every day, so I'll be fine.
If there's one or two common pitfalls, you might have better results if you limit your directions to them only. Like, if the one-way street thing is the primary issue, maybe mention it specifically, but leave off the map and all the rest. I would be much more likely to read and remember that tip if it wasn't surrounded with other info I would assume (rightly or wrongly) that I already know. (You could even still include the extensive PDF as an extra document, so that people who do want it can still access it.)
I think you are incredibly considerate for gathering all of this info for your patients, but there's only so much that people are willing or able to take in at one time. Just a thought.
posted by CtrlAltDelete at 12:18 PM on November 20, 2017 [11 favorites]
If there's one or two common pitfalls, you might have better results if you limit your directions to them only. Like, if the one-way street thing is the primary issue, maybe mention it specifically, but leave off the map and all the rest. I would be much more likely to read and remember that tip if it wasn't surrounded with other info I would assume (rightly or wrongly) that I already know. (You could even still include the extensive PDF as an extra document, so that people who do want it can still access it.)
I think you are incredibly considerate for gathering all of this info for your patients, but there's only so much that people are willing or able to take in at one time. Just a thought.
posted by CtrlAltDelete at 12:18 PM on November 20, 2017 [11 favorites]
It may be easier if you give directions from their local point or origin: i.e. have walking directions from the garage, nearby bus stops, and nearby train stations and let the parents figure out how to get to those points on their own. If you send a huge page of directions they'll start to tune out* halfway through the document, so you want to minimize extraneous information. It also gives you a reason to engage a bit more on planning out how to arrive on time:
You: I can send you directions to our office from the garage, train station, or bus stop, which one would be most helpful?
Parent: I'll be driving.
Y: I'll send you the walking directions from the garage. There's construction on X Avenue that can cause traffic delays and it takes most people about 5-10 minutes to park and walk over.
*I've literally given people explicit step by step directions from their home to our office and then sent a detailed map, only to have them search for our office on their gps, absent mindedly select a sort of similarly named facility, and then call 20 minutes after their appointment time confused about where they are. Sometimes there is nothing you can do.
posted by ghost phoneme at 12:19 PM on November 20, 2017
You: I can send you directions to our office from the garage, train station, or bus stop, which one would be most helpful?
Parent: I'll be driving.
Y: I'll send you the walking directions from the garage. There's construction on X Avenue that can cause traffic delays and it takes most people about 5-10 minutes to park and walk over.
*I've literally given people explicit step by step directions from their home to our office and then sent a detailed map, only to have them search for our office on their gps, absent mindedly select a sort of similarly named facility, and then call 20 minutes after their appointment time confused about where they are. Sometimes there is nothing you can do.
posted by ghost phoneme at 12:19 PM on November 20, 2017
As a parent with two small children, here's something you can (counterintuitively) do that will probably help with lateness: make it clear that there are a lot of entertainment options available for the kids while they are waiting -- and if you don't have any, get some.
The reason is that as a parent, without such options, trying to keep my children quiet and happy and entertained (not to mention fresh and enthusiastic for the study itself) without such things is a complete nightmare. If I suspect that entertainment is going to be difficult, I'm going to try to get there as close to exactly on time as possible, to minimise the waiting time. That is of course a recipe for lateness if the slightest thing goes wrong.
Conversely, if I can be sure that you have Legos, colouring books, blocks, etc -- actual good toys, not a few remnants of broken plastic crap that have clearly been salvaged from an Op Shop -- and a place where I can give my kids a snack or get some water without feeling like I'm destroying your waiting room with crumbs -- then I am much more likely to aim to get there early. Because I know that if I am early it'll be okay and maybe even fun.
So have all that stuff! It's entirely worth the initial outlay of money, even just $100 or $150 can buy you enough -- and emphasise VERY CLEARLY that not only are siblings welcome, but that you have stuff to entertain them while they're waiting for their appointment. I bet you'll see some of the lateness issues disappear.
posted by forza at 12:57 PM on November 20, 2017 [7 favorites]
The reason is that as a parent, without such options, trying to keep my children quiet and happy and entertained (not to mention fresh and enthusiastic for the study itself) without such things is a complete nightmare. If I suspect that entertainment is going to be difficult, I'm going to try to get there as close to exactly on time as possible, to minimise the waiting time. That is of course a recipe for lateness if the slightest thing goes wrong.
Conversely, if I can be sure that you have Legos, colouring books, blocks, etc -- actual good toys, not a few remnants of broken plastic crap that have clearly been salvaged from an Op Shop -- and a place where I can give my kids a snack or get some water without feeling like I'm destroying your waiting room with crumbs -- then I am much more likely to aim to get there early. Because I know that if I am early it'll be okay and maybe even fun.
So have all that stuff! It's entirely worth the initial outlay of money, even just $100 or $150 can buy you enough -- and emphasise VERY CLEARLY that not only are siblings welcome, but that you have stuff to entertain them while they're waiting for their appointment. I bet you'll see some of the lateness issues disappear.
posted by forza at 12:57 PM on November 20, 2017 [7 favorites]
How many of the late arrivals are not first-timers? I know about myself that if I'm going to, say, a doctor's office where there's generally a wait time, I don't mind being late because I expect to be kept waiting anyway. If things often run behind schedule at your place (because of all the hour-long sessions that start late) that can also affect the expectations of people coming back for subsequent visits.
Aside from that, timing things precisely if you're traveling by public transportation can be hard and, depending on the frequency of said transportation, people might prefer (or only be able) to come late than to arrive way earlier than needed. Is there any way to get the actual bus schedules in front of people when they're making appointments? (Assuming schedule times are reliable)
posted by trig at 1:43 PM on November 20, 2017
Aside from that, timing things precisely if you're traveling by public transportation can be hard and, depending on the frequency of said transportation, people might prefer (or only be able) to come late than to arrive way earlier than needed. Is there any way to get the actual bus schedules in front of people when they're making appointments? (Assuming schedule times are reliable)
posted by trig at 1:43 PM on November 20, 2017
My Doctor's office has people show up 15 minutes early to "fill out paperwork". I feel like the paperwork is pretty much busywork to get me in on time. I tend to show up between 15 minutes early and 5 minutes late - but the point is, it builds an extra 15 minutes into lateness. Is there random paperwork you could have them do and a TV or toys the kids can play with in advance?
posted by Toddles at 2:14 PM on November 20, 2017 [1 favorite]
posted by Toddles at 2:14 PM on November 20, 2017 [1 favorite]
If you are paying them to be there for the studies, emphasize that if they are more than X minutes late, they will not be paid or participate. They are being motivated by the money to get there; if they aren't going to get paid, they will come on time or not at all. Why should they bother to bust their ass to be on time if they know they are still getting paid?
posted by fiercecupcake at 2:46 PM on November 20, 2017 [1 favorite]
posted by fiercecupcake at 2:46 PM on November 20, 2017 [1 favorite]
I think you just need to be more firm. I would send out a courtesy email that says due to your timetable, participants are required to turn up (ten minutes or whatever) to make a 12pm appointment and that latecomers won't be admitted and will be rescheduled. Your flexibility on this is the reason it keeps happening. If people get turned away once, they'll turn up on time next time!
At my child's speech therapy, it's even more harsh. If you run too late, not only do you not get your appointment, you still get charged for it. Guess how many latecomers they have!
posted by Jubey at 5:10 PM on November 20, 2017 [1 favorite]
At my child's speech therapy, it's even more harsh. If you run too late, not only do you not get your appointment, you still get charged for it. Guess how many latecomers they have!
posted by Jubey at 5:10 PM on November 20, 2017 [1 favorite]
I recently participated in a study at a similar facility where I showed up late, and was embarrassed.
It took a long time to dig through my email to find the directions they had sent me a few weeks prior. I have too much email, and I was a little frazzled that morning by doing something outside my routine. A reminder email the day before or morning of would have been helpful. Or a text with two links: if driving, click here; if walking, click here.
I strongly prefer GPS / map app on my phone to written directions. Mostly because GPS is hands free and tells me when it's time to turn. If I don't have a passenger who can read me the directions...
At the facility I went to, there wasn't any signage saying "study participants this way -->" or similar. I don't know, maybe that was for privacy reasons. But it meant I had to keep looking back at the email on my phone: which building? Which parking garage? Which floor am I supposed to park on, and which floor of the building am I going to?
I guess someone who travels a lot has mental tricks in place to help remember that stuff, but maybe the families in your study are homebodies like me who rarely break from the home-school-work or whatever route they normally go.
posted by Former Congressional Representative Lenny Lemming at 5:29 PM on November 20, 2017 [1 favorite]
It took a long time to dig through my email to find the directions they had sent me a few weeks prior. I have too much email, and I was a little frazzled that morning by doing something outside my routine. A reminder email the day before or morning of would have been helpful. Or a text with two links: if driving, click here; if walking, click here.
I strongly prefer GPS / map app on my phone to written directions. Mostly because GPS is hands free and tells me when it's time to turn. If I don't have a passenger who can read me the directions...
At the facility I went to, there wasn't any signage saying "study participants this way -->" or similar. I don't know, maybe that was for privacy reasons. But it meant I had to keep looking back at the email on my phone: which building? Which parking garage? Which floor am I supposed to park on, and which floor of the building am I going to?
I guess someone who travels a lot has mental tricks in place to help remember that stuff, but maybe the families in your study are homebodies like me who rarely break from the home-school-work or whatever route they normally go.
posted by Former Congressional Representative Lenny Lemming at 5:29 PM on November 20, 2017 [1 favorite]
Is there a loud TV in your waiting room? If so, consider turning it off and replacing it with toys and magazines - families may be late because they're trying to minimize their time in an uncomfortably-loud waiting room (or they may be bothered by news/current affairs programs on the TV.)
Can you put in your emails/letters "parents who arrive 15 minutes before the appointment time will be offered a cup of tea/coffee"? I think that would really help.
posted by Murderbot at 7:35 PM on November 20, 2017
Can you put in your emails/letters "parents who arrive 15 minutes before the appointment time will be offered a cup of tea/coffee"? I think that would really help.
posted by Murderbot at 7:35 PM on November 20, 2017
My doctor's office has a check-in time 20 minutes before your actual appointment, and that's the time that gets emphasized in the reminder emails rather than the appointment time itself. It works well for me because for an 11am appointment, I mentally have 10:40 in my head and if I'm a little late I still get there in time for 11am. I would definitely NOT emphasize your late policy, since this is then putting 11:20 into people's heads, and then any lateness gets added onto there.
I also think you just need to feel more okay about turning people away if they miss their appointment (which is what's happening with someone who is 45 minutes late). I mean, hopefully this person is not dropping off their kid at school 45 minutes late every day or showing up to every doctor's appointment that late. Or, if they are, there are bigger problems here that you are not going to be able to single-handedly solve.
I mean, I say this as a hyper-on-time person (I recently ran up the stairs and apologized profusely about being 3 minutes late to a dentist appointment, and even then told the receptionist I would totally understand if they couldn't take me). So, probably I'm not the best person to ask. But keep in mind that a person showing up almost an HOUR late to an appointment and then having the nerve to get upset at you that they can't be seen is the one being rude. So feel free to return some of that to sender...
posted by rainbowbrite at 8:45 PM on November 20, 2017 [1 favorite]
I also think you just need to feel more okay about turning people away if they miss their appointment (which is what's happening with someone who is 45 minutes late). I mean, hopefully this person is not dropping off their kid at school 45 minutes late every day or showing up to every doctor's appointment that late. Or, if they are, there are bigger problems here that you are not going to be able to single-handedly solve.
I mean, I say this as a hyper-on-time person (I recently ran up the stairs and apologized profusely about being 3 minutes late to a dentist appointment, and even then told the receptionist I would totally understand if they couldn't take me). So, probably I'm not the best person to ask. But keep in mind that a person showing up almost an HOUR late to an appointment and then having the nerve to get upset at you that they can't be seen is the one being rude. So feel free to return some of that to sender...
posted by rainbowbrite at 8:45 PM on November 20, 2017 [1 favorite]
The reason I am late to appointments is that I am not early. Because I'm coming on public transport, it's only by aiming to be early that I would be able to be on time 100% of the time.
And the reason I am not early is that I expect I will have to wait anyway - if I go to see the doctor, I will usually be waiting a minimum of twenty minutes. If I'd arrived twenty minutes early, that would be fourty minutes spent in a grey waiting room getting nervous. Some places I can't even be sure of getting in before the stated time.
You will see a relationship to SES not only because poorer people have less reliable transport and less easy-to-control lives, but also because poorer people will even more universally expect to be kept waiting. They are not treated as if their time is valuable, and so they'll try to claim it back through passive resistance, ie arriving late.
If you actually need them to arrive on time, you need to ask them to arrive 30 minutes earlier, and then ideally have a nice environment with tea and toys and no blaring tv so that those 30 minutes are pleasantish and not something repeat visitors will go out of their way to avoid. Remember: your goal is not to get them to be on time. That works for people with cars but it doesn't work for the rest of us. You need them to [aim to] be early. Only by consciously aiming at this will you get everyone to be on time.
posted by Acheman at 7:22 AM on November 22, 2017 [5 favorites]
And the reason I am not early is that I expect I will have to wait anyway - if I go to see the doctor, I will usually be waiting a minimum of twenty minutes. If I'd arrived twenty minutes early, that would be fourty minutes spent in a grey waiting room getting nervous. Some places I can't even be sure of getting in before the stated time.
You will see a relationship to SES not only because poorer people have less reliable transport and less easy-to-control lives, but also because poorer people will even more universally expect to be kept waiting. They are not treated as if their time is valuable, and so they'll try to claim it back through passive resistance, ie arriving late.
If you actually need them to arrive on time, you need to ask them to arrive 30 minutes earlier, and then ideally have a nice environment with tea and toys and no blaring tv so that those 30 minutes are pleasantish and not something repeat visitors will go out of their way to avoid. Remember: your goal is not to get them to be on time. That works for people with cars but it doesn't work for the rest of us. You need them to [aim to] be early. Only by consciously aiming at this will you get everyone to be on time.
posted by Acheman at 7:22 AM on November 22, 2017 [5 favorites]
I also work in a place where low-income people have specific appointment times and are often late, despite good directions. You've gotten some helpful suggestions above, but I want to share a quotation I found in Alice Goffman's book On the Run: Fugitive Life in an American City that helped me understand the lateness a little better:
"Amid the swiftly changing fortunes and limited resources of Mike and Chuck and their friends on 6th Street, a promise to be somewhere in the future is understood as a wish in the moment more than a concrete eventuality or binding contract."
posted by southern_sky at 2:36 PM on November 24, 2017
"Amid the swiftly changing fortunes and limited resources of Mike and Chuck and their friends on 6th Street, a promise to be somewhere in the future is understood as a wish in the moment more than a concrete eventuality or binding contract."
posted by southern_sky at 2:36 PM on November 24, 2017
because poorer people will even more universally expect to be kept waiting. They are not treated as if their time is valuable,
Giving them a fake early time and making them wait is reinforcing that you don't value their time. Can appointments be scheduled as normal but then one staff member be scheduled as a floater that takes the late appointments so everyone else can stay on schedule? Are there non-study tasks they can do between appointments? It would depend on how many staff you have and how many appointments you normally have in a day.
posted by saucysault at 11:14 AM on December 1, 2017
Giving them a fake early time and making them wait is reinforcing that you don't value their time. Can appointments be scheduled as normal but then one staff member be scheduled as a floater that takes the late appointments so everyone else can stay on schedule? Are there non-study tasks they can do between appointments? It would depend on how many staff you have and how many appointments you normally have in a day.
posted by saucysault at 11:14 AM on December 1, 2017
This reddit post may have some info you find useful.
posted by saucysault at 12:32 PM on December 18, 2017 [1 favorite]
posted by saucysault at 12:32 PM on December 18, 2017 [1 favorite]
This study made me think of your question: Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments, A Clinical Trial
posted by fiercecupcake at 7:33 AM on February 7, 2018
posted by fiercecupcake at 7:33 AM on February 7, 2018
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posted by k8t at 10:01 AM on November 20, 2017