Post by Tanya Munroe on Jan 31, 2018 10:39:27 GMT -5
We were recently asked what typical no-show rates are for Centering. Then an interesting discussion started...
Do you have any creative strategies to ensure that group size for session 1 is appropriate?
- This has come up a lot with my sites and they overwhelmingly report that the Centering no show rates mirror their clinic no show rates. I know the goal is to see this change in Centering’s favor over time. The new CenteringCounts online is going to help CHI & our sites gather some easily accessible data.
- The data CHI has today is what our approved sites report to us via CenteringCounts. The average CenteringPregnancy patient attends 6-7 group sessions (out of 10) and the average CenteringPregnancy practice has a dropout rate of roughly 10% (patients that leave after the first session). We do not collect data on patients that are enrolled but never attend group. We know anecdotally that many sites deliberately over enroll with the expectation that several patients will never show or drop out. Of course the context to this entire discussion is that it all depends on your enrollment practices and the quality of your facilitation.
- The important thing to remember when enrolling is: have all the mom's questions been answered and any barriers removed (social marketing) and then probably the next most important point is how facilitative was the first session? Was the first session fun, engaging and patient-centered? Without those elements the patients will not return. This point needs to be understood by all facilitators. It is their responsibility to see that the above elements have happened. Make sure co-facilitators debrief each session using the Facilitator Process Evaluation with a true reflection on how did the session go so that they can grow in their facilitation skills. If a site's no show rate does NOT improve from the clinic's rate then something is wrong! This would be a major stumbling block for sustainability! As consultants, this would be our responsibility to address this with the facilitators and discuss how the issue can be improved or resolved.
- I also want to share that this has been studied in the CenteringPregnancy literature focused both on routine prenatal care visit attendance and postpartum visit attendance. Studies report improved attendance rate in CenteringPregnancy compared with individual prenatal care (referred to as IPC in the attached). If sites are seeing higher rates of no-shows in groups, something is going wrong with their overall enrollment/recruitment process Visit Adherence.xlsx (25.87 KB)
- Another consideration around show rates is the overbooking of patients for the first group (over enrolling by 50-80% over group number sometimes) to get an acceptable number to show for the first group. I’ve seen this dramatically effect and lower overall show rate. Many of these patients never show for a Centering group and are sometimes included in the no show numbers for the first 2-3 groups.
Do you have any creative strategies to ensure that group size for session 1 is appropriate?
- This has come up a lot with my sites and they overwhelmingly report that the Centering no show rates mirror their clinic no show rates. I know the goal is to see this change in Centering’s favor over time. The new CenteringCounts online is going to help CHI & our sites gather some easily accessible data.
- The data CHI has today is what our approved sites report to us via CenteringCounts. The average CenteringPregnancy patient attends 6-7 group sessions (out of 10) and the average CenteringPregnancy practice has a dropout rate of roughly 10% (patients that leave after the first session). We do not collect data on patients that are enrolled but never attend group. We know anecdotally that many sites deliberately over enroll with the expectation that several patients will never show or drop out. Of course the context to this entire discussion is that it all depends on your enrollment practices and the quality of your facilitation.
- The important thing to remember when enrolling is: have all the mom's questions been answered and any barriers removed (social marketing) and then probably the next most important point is how facilitative was the first session? Was the first session fun, engaging and patient-centered? Without those elements the patients will not return. This point needs to be understood by all facilitators. It is their responsibility to see that the above elements have happened. Make sure co-facilitators debrief each session using the Facilitator Process Evaluation with a true reflection on how did the session go so that they can grow in their facilitation skills. If a site's no show rate does NOT improve from the clinic's rate then something is wrong! This would be a major stumbling block for sustainability! As consultants, this would be our responsibility to address this with the facilitators and discuss how the issue can be improved or resolved.
- I also want to share that this has been studied in the CenteringPregnancy literature focused both on routine prenatal care visit attendance and postpartum visit attendance. Studies report improved attendance rate in CenteringPregnancy compared with individual prenatal care (referred to as IPC in the attached). If sites are seeing higher rates of no-shows in groups, something is going wrong with their overall enrollment/recruitment process Visit Adherence.xlsx (25.87 KB)
- Another consideration around show rates is the overbooking of patients for the first group (over enrolling by 50-80% over group number sometimes) to get an acceptable number to show for the first group. I’ve seen this dramatically effect and lower overall show rate. Many of these patients never show for a Centering group and are sometimes included in the no show numbers for the first 2-3 groups.