Administrative Changes to Decrease Patient Absenteeism: A Quality Improvement Project

Abstract

Patient no-shows are individuals who fail to attend outpatient medical appointments without notification. This detrimental behavior leads to poor health outcomes, decrease in access to care, and financial losses. A literature review showed that enhancing communication techniques related to appointment reminders can lower non-attendance rates in a variety of outpatient clinic settings. Evidence-based information led to the formation of a quality improvement project with the aim of improving patient attendance with new communication techniques. Interventions included collecting data daily about all no-shows, performing a manual telephone reminder 24 hours prior to the scheduled appointment, and surveying the current patient population regarding their preferences for appointment reminders. The results revealed that the clinic no-show rate decreased from 7% to 1.3% during the eight-week project implementation. In addition, patient survey data demonstrated that 41% of the participants wished to have their reminder messages sent by text message; yet only 10% of the population were receiving them. Implications of the manual phone call reminders were an improved no-show rates despite patients’ preferences for text message reminders. Future projects directed at enrolling patient cellphone numbers as the primary SMS appointment reminder may be both desirable and beneficial.