Glossary
What a missed appointment is, and how it differs from a no-show
Almost every discussion about missed appointments starts with two people looking at different figures for the same service and the same month. One counts hours, the other counts patients. One includes provider-side cancellations, the other strips them out.
| Category | What happened | Who can prevent it |
|---|---|---|
| Cancellation in time | The patient gives notice and the slot goes back on offer | The patient, given an easy channel |
| Late cancellation | Notice arrives too late to refill the slot | The reminder, if it lands earlier |
| No-show | The patient neither arrives nor calls | Confirmation and rebooking |
| Provider cancellation | The site moves or cancels the appointment | The provider itself |
Large systems draw the same lines in writing. VHA Directive 1230 classifies a no show as a patient who was not present and gave the clinic no notice, and keeps that category apart from cancelled by clinic and cancelled by patient.
Why does one service report two different rates?
Because the denominator changes by department. The contact centre measures against the hours it worked, the clinical service against the hours it opened, finance against the services it expected to bill. All three can be correctly calculated and still disagree. Settling the denominator before arguing about the percentage saves whole meetings.
The interesting reading runs the other way. A service with a low missed-appointment rate and a long waiting list has a distribution problem, however healthy its number looks. Our own counting rules are in how we measure results.