Nudges: A Behavioural Approach for Mitigating Missed Appointments at a Private Dental Clinic in Saudi Arabia

Abstract

Missed appointments continue to bedevil private healthcare providers globally. It implies failure by a patient to arrive for an appointment or to cancel an appointment in advance. Clinics management plays an important role in mitigating no-shows among their patients. Some interventions have been implemented, such as sending reminder messages to patients about their upcoming appointments and imposing sanctions against those who fail to attend. However, the interventions have yet to mitigate the challenge completely. As a result, it is essential to explore alternative interventions with behavioural economics approaches considered more effective. Nudge theory is a behavioural theory, which seeks to influence the attainment of desired decisions among various populations, in this context, patients with clinical appointments. Subsequently, the review sought to assess the effectiveness of nudges in mitigating missed appointments. Methodology The study adopted a narrative literature review methodology to examine the use of nudges in mitigating missed appointments within Nayel Clinics (NC), a private dental health facility in Saudi Arabia. The adoption of nudges is analysed based on its influence on behaviour and appointment attendance. Findings The review concluded that missed appointments pose significant financial losses to clinics. However, the application of behavioural nudges was found to evoke more profound thoughts and analysis among patients leading to desirable decisions. The effective practices identified and recommended for applying nudges in NC involve developing an exclusive loyalty programme, creating a feedback loop for patients, and digitising the appointment confirmation process. These recommendations are suggested to encourage patients to attend clinical appointments or to make timely cancellations. Research limitations The study adopted a narrative literature review rather than a meta-analysis to explore interventions for missed appointments. Consequently, the findings may not have yielded precise recommendations. Additionally, the methodological quality of the reviewed studies varied, which may have influenced the outcomes. Future studies should focus on generating empirical evidence to validate the findings presented in the current review. Practical implications No-shows negatively impact healthcare systems globally by decreasing continuity of care and clinic capacity. Healthcare providers can implement recommendations from this review to increase appointment attendance. Keywords Missed appointments, No-show, Nudge theory, Nudge, Kingdom of Saudi Arabia, patient, behavioural economics, hospital, management. Article classification Research paper, A critical evaluation of nudge theory.